System and method to enable remote adjustment of a device during a telemedicine session

ABSTRACT

A computer-implemented system comprising a treatment device, a patient interface, and a processing device is disclosed. The treatment device is configured to be manipulated by a user while the user performs a treatment plan. The patient interface comprises an output device configured to present telemedicine information associated with a telemedicine session. The processing device is configured to receive a treatment plan for a patient; during the telemedicine session, use the treatment plan to generate at least one parameter; and responsive to at least one trigger condition occurring, control at least one operation of the device.

CROSS-REFERENCES TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No. 17/379,524, filed Jul. 19, 2021, titled “System and Method to Enable Remote Adjustment of a Device During a Telemedicine Session”, which is a continuation of U.S. patent application Ser. No. 17/147,514, filed Jan. 13, 2021, titled “System and Method to Enable Remote Adjustment of a Device During a Telemedicine Session”, which claims priority to and the benefit of U.S. Prov. Pat. App. No. 63/029,896, filed May 26, 2020, titled “System and Method to Enable Remote Adjustment of a Device During a Telemedicine Session”. U.S. patent application Ser. No. 17/147,514 is also a continuation-in-part of U.S. patent application Ser. No. 17/021,895, filed Sep. 15, 2020, titled “Telemedicine for Orthopedic Treatment” which claims priority to and the benefit of U.S. Prov. Pat. App. 62/910,232 filed Oct. 3, 2019, titled “Telemedicine for Orthopedic Treatment”. The entire disclosures of the above-referenced applications are hereby incorporated by reference for all purposes.

TECHNICAL FIELD

This disclosure relates generally to a system and a method for enabling a remote adjustment of a device during a telemedicine session.

BACKGROUND

Remote medical assistance, also referred to, inter alia, as remote medicine, telemedicine, telemed, telmed, tel-med, or telehealth, is an at least two-way communication between a healthcare provider or providers, such as a physician or a physical therapist, and a patient using audio and/or audiovisual and/or other sensorial or perceptive (e.g., tactile, gustatory, haptic, pressure-sensing-based or electromagnetic (e.g., neurostimulation) communications (e.g., via a computer, a smartphone, or a tablet). Telemedicine may aid a patient in performing various aspects of a rehabilitation regimen for a body part. The patient may use a patient interface in communication with an assistant interface for receiving the remote medical assistance via audio, visual, audiovisual, or other communications described elsewhere herein. Any reference herein to any particular sensorial modality shall be understood to include and to disclose by implication a different one or more sensory modalities.

Telemedicine is an option for healthcare providers to communicate with patients and provide patient care when the patients do not want to or cannot easily go to the healthcare providers' offices. Telemedicine, however, has substantive limitations as the healthcare providers cannot conduct physical examinations of the patients. Rather, the healthcare providers must rely on verbal communication and/or limited remote observation of the patients.

SUMMARY

In general, the present disclosure provides a system and method for remote examination of patients through augmentation.

An aspect of the disclosed embodiments includes a computer-implemented system comprising a treatment device, a patient interface, and a processing device. The treatment device is configured to be manipulated by a user while the user performs a treatment plan. The patient interface comprises an output device configured to present telemedicine information associated with a telemedicine session. The processing device is configured to receive a treatment plan for a patient; during the telemedicine session, use the treatment plan to generate at least one parameter; and responsive to at least one trigger condition occurring, control at least one operation of the device.

Another aspect of the disclosed embodiments includes a system for enabling a remote adjustment of a device. The system comprises a control system comprising one or more processing devices operatively coupled to the device. The one or more processing devices are configured to receive a treatment plan for a patient; use the treatment plan to generate at least one parameter; and responsive to at least one trigger condition occurring, control at least one operation of the device.

Another aspect of the disclosed embodiments includes a system that includes a processing device and a memory communicatively coupled to the processing device and capable of storing instructions. The processing device executes the instructions to perform any of the methods, operations, or steps described herein.

Another aspect of the disclosed embodiments includes a tangible, non-transitory computer-readable medium storing instructions that, when executed, cause a processing device to perform any of the methods, operations, or steps described herein.

BRIEF DESCRIPTION OF THE DRAWINGS

For a more complete understanding of this disclosure and its advantages, reference is now made to the following description, taken in conjunction with the accompanying drawings. It is emphasized that, according to common practice, the various features of the drawings are not to-scale. On the contrary, the dimensions of the various features are arbitrarily expanded or reduced for clarity.

FIG. 1 generally illustrates a high-level component diagram of an illustrative system according to certain aspects of this disclosure.

FIGS. 2A-D generally illustrate example treatment devices according to certain aspects of this disclosure.

FIG. 3 generally illustrates an example master device according to certain aspects of this disclosure.

FIGS. 4A-D generally illustrate example augmented images according to certain aspects of this disclosure.

FIG. 5 generally illustrates an example method of operating a remote examination system according to certain aspects of this disclosure.

FIG. 6 generally illustrates an example method of operating a remote examination system according to certain aspects of this disclosure.

FIG. 7 generally illustrates a high-level component diagram of an illustrative system for a remote adjustment of a device according to certain aspects of this disclosure.

FIG. 8 generally illustrates a perspective view of an example of the device according to certain aspects of this disclosure.

FIG. 9 generally illustrates an example method of enabling a remote adjustment of a device according to certain aspects of this disclosure.

FIG. 10 generally illustrates an example computer system according to certain to certain aspects of this disclosure.

FIG. 11 generally illustrates a perspective view of an embodiment of the device, such as a treatment device according to certain aspects of this disclosure.

FIG. 12 generally illustrates a perspective view of a pedal of the treatment device of FIG. 11 according to certain aspects of this disclosure.

FIG. 13 generally illustrates a perspective view of a person using the treatment device of FIG. 11 according to certain aspects of this disclosure.

NOTATION AND NOMENCLATURE

Various terms are used to refer to particular system components. Different companies may refer to a component by different names—this document does not intend to distinguish between components that differ in name but not function. In the following discussion and in the claims, the terms “including” and “comprising” are used in an open-ended fashion, and thus should be interpreted to mean “including, but not limited to . . . .” Also, the term “couple” or “couples” is intended to mean either an indirect or direct connection. Thus, if a first device couples to a second device, that connection may be through a direct connection or through an indirect connection via other devices and connections.

The terminology used herein is for the purpose of describing particular example embodiments only, and is not intended to be limiting. As used herein, the singular forms “a,” “an,” and “the” may be intended to include the plural forms as well, unless the context clearly indicates otherwise. The method steps, processes, and operations described herein are not to be construed as necessarily requiring their performance in the particular order discussed or illustrated, unless specifically identified as an order of performance. It is also to be understood that additional or alternative steps may be employed.

The terms first, second, third, etc. may be used herein to describe various elements, components, regions, layers and/or sections; however, these elements, components, regions, layers and/or sections should not be limited by these terms. These terms may be only used to distinguish one element, component, region, layer, or section from another region, layer, or section. Terms such as “first,” “second,” and other numerical terms, when used herein, do not imply a sequence or order unless clearly indicated by the context. Thus, a first element, component, region, layer, or section discussed below could be termed a second element, component, region, layer, or section without departing from the teachings of the example embodiments. The phrase “at least one of,” when used with a list of items, means that different combinations of one or more of the listed items may be used, and only one item in the list may be needed. For example, “at least one of: A, B, and C” includes any of the following combinations: A, B, C, A and B, A and C, B and C, and A and B and C. In another example, the phrase “one or more” when used with a list of items means there may be one item or any suitable number of items exceeding one.

Spatially relative terms, such as “inner,” “outer,” “beneath,” “below,” “lower,” “above,” “upper,” “top,” “bottom,” “inside,” “outside,” “contained within,” “superimposing upon,” and the like, may be used herein. These spatially relative terms can be used for ease of description to describe one element's or feature's relationship to another element(s) or feature(s) as illustrated in the figures. The spatially relative terms may also be intended to encompass different orientations of the device in use, or operation, in addition to the orientation depicted in the figures. For example, if the device in the figures is turned over, elements described as “below” or “beneath” other elements or features would then be oriented “above” the other elements or features. Thus, the example term “below” can encompass both an orientation of above and below. The device may be otherwise oriented (rotated 90 degrees or at other orientations) and the spatially relative descriptions used herein interpreted accordingly.

A “treatment plan” may include one or more treatment protocols, and each treatment protocol includes one or more treatment sessions. Each treatment session comprises several session periods, with each session period including a particular exercise for treating the body part of the patient. For example, a treatment plan for post-operative rehabilitation after a knee surgery may include an initial treatment protocol with twice daily stretching sessions for the first 3 days after surgery and a more intensive treatment protocol with active exercise sessions performed 4 times per day starting 4 days after surgery. A treatment plan may also include information pertaining to a medical procedure to perform on the patient, a treatment protocol for the patient using a treatment device, a diet regimen for the patient, a medication regimen for the patient, a sleep regimen for the patient, additional regimens, or some combination thereof.

The terms telemedicine, telehealth, telemed, teletherapeutic, telemedicine, remote medicine, etc. may be used interchangeably herein.

The term “optimal treatment plan” may refer to optimizing a treatment plan based on a certain parameter or factors or combinations of more than one parameter or factor, such as, but not limited to, a measure of benefit which one or more exercise regimens provide to users, one or more probabilities of users complying with one or more exercise regimens, an amount, quality or other measure of sleep associated with the user, information pertaining to a diet of the user, information pertaining to an eating schedule of the user, information pertaining to an age of the user, information pertaining to a sex of the user, information pertaining to a gender of the user, an indication of a mental state of the user, information pertaining to a genetic condition of the user, information pertaining to a disease state of the user, an indication of an energy level of the user, information pertaining to a microbiome from one or more locations on or in the user (e.g., skin, scalp, digestive tract, vascular system, etc.), or some combination thereof.

As used herein, the term healthcare provider may include a medical professional (e.g., such as a doctor, a nurse, a therapist, and the like), an exercise professional (e.g., such as a coach, a trainer, a nutritionist, and the like), or another professional sharing at least one of medical and exercise attributes (e.g., such as an exercise physiologist, a physical therapist, an occupational therapist, and the like). As used herein, and without limiting the foregoing, a “healthcare provider” may be a human being, a robot, a virtual assistant, a virtual assistant in virtual and/or augmented reality, or an artificially intelligent entity, such entity including a software program, integrated software and hardware, or hardware alone.

DETAILED DESCRIPTION

The following discussion is directed to various embodiments of the present disclosure. Although one or more of these embodiments may be preferred, the embodiments disclosed should not be interpreted, or otherwise used, as limiting the scope of the disclosure, including the claims. In addition, one skilled in the art will understand that the following description has broad application, and the discussion of any embodiment is meant only to be exemplary of that embodiment, and not intended to intimate that the scope of the disclosure, including the claims, is limited to that embodiment.

Determining optimal remote examination procedures to create an optimal treatment plan for a patient having certain characteristics (e.g., vital-sign or other measurements; performance; demographic; geographic; psychographic; diagnostic; measurement- or test-based; medically historic; behavioral historic; cognitive; etiologic; cohort-associative; differentially diagnostic; surgical, physically therapeutic, pharmacologic and other treatment(s) recommended; etc.) may be a technically challenging problem. For example, a multitude of information may be considered when determining a treatment plan, which may result in inefficiencies and inaccuracies in the treatment plan selection process. In a rehabilitative setting, some of the multitude of information considered may include characteristics of the patient such as personal information, performance information, and measurement information. The personal information may include, e.g., demographic, psychographic or other information, such as an age, a weight, a gender, a height, a body mass index, a medical condition, a familial medication history, an injury, a medical procedure, a medication prescribed, or some combination thereof. The performance information may include, e.g., an elapsed time of using a treatment device, an amount of force exerted on a portion of the treatment device, a range of motion achieved on the treatment device, a movement speed of a portion of the treatment device, a duration of use of the treatment device, an indication of a plurality of pain levels using the treatment device, or some combination thereof. The measurement information may include, e.g., a vital sign, a respiration rate, a heartrate, a temperature, a blood pressure, a glucose level or other biomarker, or some combination thereof. It may be desirable to process and analyze the characteristics of a multitude of patients, the treatment plans performed for those patients, and the results of the treatment plans for those patients.

Further, another technical problem may involve distally treating, via a computing device during a telemedicine session, a patient from a location different than a location at which the patient is located. An additional technical problem is controlling or enabling, from the different location, the control of a treatment apparatus used by the patient at the patient's location. Oftentimes, when a patient undergoes rehabilitative surgery (e.g., knee surgery), a medical professional may prescribe a treatment apparatus to the patient to use to perform a treatment protocol at their residence or at any mobile location or temporary domicile. A medical professional may refer to a doctor, physician assistant, nurse, chiropractor, dentist, physical therapist, acupuncturist, physical trainer, or the like. A medical professional may refer to any person with a credential, license, degree, or the like in the field of medicine, physical therapy, rehabilitation, or the like.

When the healthcare provider is located in a location different from the patient and the treatment device, it may be technically challenging for the healthcare provider to monitor the patient's actual progress (as opposed to relying on the patient's word about their progress) in using the treatment device, modify the treatment plan according to the patient's progress, adapt the treatment device to the personal characteristics of the patient as the patient performs the treatment plan, and the like. Further, in addition to the information described above, determining optimal examination procedures for a particular ailment (e.g., injury, disease, any applicable medical condition, etc.) may include physically examining the injured body part of a patient. The healthcare provider, such as a physician or a physical therapist, may visually inspect the injured body part (e.g., a knee joint). The inspection may include looking for signs of inflammation or injury (e.g., swelling, redness, and warmth), deformity (e.g., symmetrical joints and abnormal contours and/or appearance), or any other suitable observation. To determine limitations of the injured body part, the healthcare provider may observe the injured body part as the patient attempts to perform normal activity (e.g., bending and extending the knee and gauging any limitations to the range of motion of the injured knee). The healthcare provide may use one or more hands and/or fingers to touch the injured body part. By applying pressure to the injured body part, the healthcare provider can obtain information pertaining to the extent of the injury. For example, the healthcare provider's fingers may palpate the injured body part to determine if there is point tenderness, warmth, weakness, strength, or to make any other suitable observation.

It may be desirable to compare characteristics of the injured body part with characteristics of a corresponding non-injured body part to determine what an optimal treatment plan for the patient may be such that the patient can obtain a desired result. Thus, the healthcare provider may examine a corresponding non-injured body part of the patient. For example, the healthcare provider's fingers may palpate a non-injured body part (e.g., a left knee) to determine a baseline of how the patient's non-injured body part feels and functions. The healthcare provider may use the results of the examination of the non-injured body part to determine the extent of the injury to the corresponding injured body part (e.g., a right knee). Additionally, injured body parts may affect other body parts (e.g., a knee injury may limit the use of the affected leg, leading to atrophy of leg muscles). Thus, the healthcare provider may also examine additional body parts of the patient for evidence of atrophy of or injury to surrounding ligaments, tendons, bones, and muscles, examples of muscles being such as quadriceps, hamstrings, or calf muscle groups of the leg with the knee injury. The healthcare provider may also obtain information as to a pain level that the patient reports or experiences before, during, and/or after the examination.

The healthcare provider can use the information obtained from the examination (e.g., the results of the examination) to determine a proper treatment plan for the patient. If the healthcare provider cannot conduct a physical examination of the one or more body parts of the patient, the healthcare provider may not be able to fully assess the patient's injury and the treatment plan may not be optimal. Accordingly, embodiments of the present disclosure pertain to systems and methods for conducting a remote examination of a patient. The remote examination system provides the healthcare provider with the ability to conduct a remote examination of the patient, not only by communicating with the patient, but by virtually observing and/or feeling the patient's one or more body parts.

In some embodiments, the systems and methods described herein may be configured to use a treatment device configured to be manipulated by an individual while the user performs a treatment plan. The individual may include a user, patient, or other a person using the treatment device to perform various exercises for prehabilitation, rehabilitation, stretch training, and the like. The systems and methods described herein may be configured to use and/or provide a patient interface comprising an output device configured to present telemedicine information associated with a telemedicine session.

In some embodiments, the systems and methods described herein may be configured to receive a treatment plan for a patient; during the telemedicine session, use the treatment plan to generate at least one parameter; and responsive to at least one trigger condition occurring, control at least one operation of the device. Any or all of the methods described may be implemented during a telemedicine session or at any other desired time.

In some embodiments, the treatment devices may be communicatively coupled to a server. Characteristics of the patients, including the treatment data, may be collected before, during, and/or after the patients perform the treatment plans. For example, any or each of the personal information, the performance information, and the measurement information may be collected before, during, and/or after a patient performs the treatment plans. The results (e.g., improved performance or decreased performance) of performing each exercise may be collected from the treatment device throughout the treatment plan and after the treatment plan is performed. The parameters, settings, configurations, etc. (e.g., position of pedal, amount of resistance, etc.) of the treatment device may be collected before, during, and/or after the treatment plan is performed.

Each characteristic of the patient, each result, and each parameter, setting, configuration, etc. may be timestamped and may be correlated with a particular step or set of steps in the treatment plan. Such a technique may enable the determination of which steps in the treatment plan lead to desired results (e.g., improved muscle strength, range of motion, etc.) and which steps lead to diminishing returns (e.g., continuing to exercise after 3 minutes actually delays or harms recovery).

Data may be collected from the treatment devices and/or any suitable computing device (e.g., computing devices where personal information is entered, such as the interface of the computing device described herein, a clinician interface, patient interface, and the like) over time as the patients use the treatment devices to perform the various treatment plans. The data that may be collected may include the characteristics of the patients, the treatment plans performed by the patients, the results of the treatment plans, any of the data described herein, any other suitable data, or a combination thereof.

In some embodiments, the data may be processed to group certain people into cohorts. The people may be grouped by people having certain or selected similar characteristics, treatment plans, and results of performing the treatment plans. For example, athletic people having no medical conditions who perform a treatment plan (e.g., use the treatment device for 30 minutes a day 5 times a week for 3 weeks) and who fully recover may be grouped into a first cohort. Older people who are classified obese and who perform a treatment plan (e.g., use the treatment plan for 10 minutes a day 3 times a week for 4 weeks) and who improve their range of motion by 75 percent may be grouped into a second cohort.

In some embodiments, an artificial intelligence engine may include one or more machine learning models that are trained using the cohorts. In some embodiments, the artificial intelligence engine may be used to identify trends and/or patterns and to define new cohorts based on achieving desired results from the treatment plans and machine learning models associated therewith may be trained to identify such trends and/or patterns and to recommend and rank the desirability of the new cohorts. For example, the one or more machine learning models may be trained to receive an input of characteristics of a new patient and to output a treatment plan for the patient that results in a desired result. The machine learning models may match a pattern between the characteristics of the new patient and at least one patient of the patients included in a particular cohort. When a pattern is matched, the machine learning models may assign the new patient to the particular cohort and select the treatment plan associated with the at least one patient. The artificial intelligence engine may be configured to control, distally and based on the treatment plan, the treatment device while the new patient uses the treatment device to perform the treatment plan.

As may be appreciated, the characteristics of the new patient (e.g., a new user) may change as the new patient uses the treatment device to perform the treatment plan. For example, the performance of the patient may improve quicker than expected for people in the cohort to which the new patient is currently assigned. Accordingly, the machine learning models may be trained to dynamically reassign, based on the changed characteristics, the new patient to a different cohort that includes people having characteristics similar to the now-changed characteristics as the new patient. For example, a clinically obese patient may lose weight and no longer meet the weight criterion for the initial cohort, result in the patient's being reassigned to a different cohort with a different weight criterion.

A different treatment plan may be selected for the new patient, and the treatment device may be controlled, distally (e.g., which may be referred to as remotely) and based on the different treatment plan, while the new patient uses the treatment device to perform the treatment plan. Such techniques may provide the technical solution of distally controlling a treatment device.

Further, the systems and methods described herein may lead to faster recovery times and/or better results for the patients because the treatment plan that most accurately fits their characteristics is selected and implemented, in real-time, at any given moment. “Real-time” may also refer to near real-time, which may be less than 10 seconds or any reasonably proximate difference between two different times. As described herein, the term “results” may refer to medical results or medical outcomes. Results and outcomes may refer to responses to medical actions. The term “medical action(s)” may refer to any suitable action performed by the medical professional, and such action or actions may include diagnoses, prescription of treatment plans, prescription of treatment devices, and the making, composing and/or executing of appointments, telemedicine sessions, prescription of medicines, telephone calls, emails, text messages, and the like.

Depending on what result is desired, the artificial intelligence engine may be trained to output several treatment plans. For example, one result may include recovering to a threshold level (e.g., 75% range of motion) in a fastest amount of time, while another result may include fully recovering (e.g., 100% range of motion) regardless of the amount of time. The data obtained from the patients and sorted into cohorts may indicate that a first treatment plan provides the first result for people with characteristics similar to the patient's, and that a second treatment plan provides the second result for people with characteristics similar to the patient.

Further, the artificial intelligence engine may be trained to output treatment plans that are not optimal i.e., sub-optimal, nonstandard, or otherwise excluded (all referred to, without limitation, as “excluded treatment plans”) for the patient. For example, if a patient has high blood pressure, a particular exercise may not be approved or suitable for the patient as it may put the patient at unnecessary risk or even induce a hypertensive crisis and, accordingly, that exercise may be flagged in the excluded treatment plan for the patient. In some embodiments, the artificial intelligence engine may monitor the treatment data received while the patient (e.g., the user) with, for example, high blood pressure, uses the treatment device to perform an appropriate treatment plan and may modify the appropriate treatment plan to include features of an excluded treatment plan that may provide beneficial results for the patient if the treatment data indicates the patient is handling the appropriate treatment plan without aggravating, for example, the high blood pressure condition of the patient. In some embodiments, the artificial intelligence engine may modify the treatment plan if the monitored data shows the plan to be inappropriate or counterproductive for the user.

In some embodiments, the treatment plans and/or excluded treatment plans may be presented, during a telemedicine or telehealth session, to a healthcare provider. The healthcare provider may select a particular treatment plan for the patient to cause that treatment plan to be transmitted to the patient and/or to control, based on the treatment plan, the treatment device. In some embodiments, to facilitate telehealth or telemedicine applications, including remote diagnoses, determination of treatment plans and rehabilitative and/or pharmacologic prescriptions, the artificial intelligence engine may receive and/or operate distally from the patient and the treatment device.

In such cases, the recommended treatment plans and/or excluded treatment plans may be presented simultaneously with a video of the patient in real-time or near real-time during a telemedicine or telehealth session on a user interface of a computing device of a medical professional. The video may also be accompanied by audio, text and other multimedia information and/or other sensorial or perceptive (e.g., tactile, gustatory, haptic, pressure-sensing-based or electromagnetic (e.g., neurostimulation). Real-time may refer to less than or equal to 2 seconds. Near real-time may refer to any interaction of a sufficiently short time to enable two individuals to engage in a dialogue via such user interface, and will generally be less than 10 seconds (or any suitably proximate difference between two different times) but greater than 2 seconds.

Presenting the treatment plans generated by the artificial intelligence engine concurrently with a presentation of the patient video may provide an enhanced user interface because the healthcare provider may continue to visually and/or otherwise communicate with the patient while also reviewing the treatment plans on the same user interface. The enhanced user interface may improve the healthcare provider's experience using the computing device and may encourage the healthcare provider to reuse the user interface. Such a technique may also reduce computing resources (e.g., processing, memory, network) because the healthcare provider does not have to switch to another user interface screen to enter a query for a treatment plan to recommend based on the characteristics of the patient. The artificial intelligence engine may be configured to provide, dynamically on the fly, the treatment plans and excluded treatment plans.

In some embodiments, the treatment device may be adaptive and/or personalized because its properties, configurations, and positions may be adapted to the needs of a particular patient. For example, the pedals may be dynamically adjusted on the fly (e.g., via a telemedicine session or based on programmed configurations in response to certain measurements being detected) to increase or decrease a range of motion to comply with a treatment plan designed for the user. In some embodiments, a healthcare provider may adapt, remotely during a telemedicine session, the treatment device to the needs of the patient by causing a control instruction to be transmitted from a server to treatment device. Such adaptive nature may improve the results of recovery for a patient, furthering the goals of personalized medicine, and enabling personalization of the treatment plan on a per-individual basis.

FIGS. 1-13, discussed below, and the various embodiments used to describe the principles of this disclosure are by way of illustration only and should not be construed in any way to limit the scope of the disclosure.

FIG. 1 illustrates a high-level component diagram of an illustrative remote examination system 100 according to certain embodiments of this disclosure. In some embodiments, the remote examination system 100 may include a slave computing device 102 communicatively coupled to a slave device, such as a treatment device 106. The treatment device can include a slave sensor 108 and a slave pressure system 110. The slave pressure system can include a slave motor 112. The remote examination system may also be communicatively coupled to an imaging device 116. Each of the slave computing device 102, the treatment device 106, and the imaging device 116 may include one or more processing devices, memory devices, and network interface cards. The network interface cards may enable communication via a wireless protocol for transmitting data over short distances, such as Bluetooth, ZigBee, etc. In some embodiments, the slave computing device 102 is communicatively coupled to the treatment device 106 and the imaging device 116 via Bluetooth.

Additionally, the network interface cards may enable communicating data over long distances, and in one example, the slave computing device 102 may communicate with a network 104. The network 104 may be a public network (e.g., connected to the Internet via wired (Ethernet) or wireless (WiFi)), a private network (e.g., a local area network (LAN) or wide area network (WAN)), or a combination thereof. The slave computing device 102 may be communicatively coupled with one or more master computing devices 122 and a cloud-based computing system 142.

The slave computing device 102 may be any suitable computing device, such as a laptop, tablet, smartphone, or computer. The slave computing device 102 may include a display capable of presenting a user interface, such as a patient portal 114. The patient portal 114 may be implemented in computer instructions stored on the one or more memory devices of the slave computing device 102 and executable by the one or more processing devices of the slave computing device 102. The patient portal 114 may present various screens to a patient that enable the patient to view his or her medical records, a treatment plan, or progress during the treatment plan; to initiate a remote examination session; to control parameters of the treatment device 106; to view progress of rehabilitation during the remote examination session; or combination thereof. The slave computing device 102 may also include instructions stored on the one or more memory devices that, when executed by the one or more processing devices of the slave computing device 102, perform operations to control the treatment device 106.

The slave computing device 102 may execute the patient portal 114. The patient portal 114 may be implemented in computer instructions stored on the one or more memory devices of the slave computing device 102 and executable by the one or more processing devices of the slave computing device 102. The patient portal 114 may present various screens to a patient which enable the patient to view a remote examination provided by a healthcare provider, such as a physician or a physical therapist. The patient portal 114 may also provide remote examination information for a patient to view. The examination information can include a summary of the examination and/or results of the examination in real-time or near real-time, such as measured properties (e.g., angles of bend/extension, pressure exerted on the treatment device 106, images of the examined/treated body part, vital signs of the patient, such as heart rate, temperature, etc.) of the patient during the examination. The patient portal 114 may also provide the patient's health information, such as a health history, a treatment plan, and a progress of the patient throughout the treatment plan. So the examination of the patient may begin, the examination information specific to the patient may be transmitted via the network 104 to the cloud-based computing system 142 for storage and/or to the slave computing device 102.

The treatment device 106 may be an examination device for a body part of a patient. As illustrated in FIGS. 2A-D, the treatment device 106 can be configured in alternative arrangements and is not limited to the example embodiments described in this disclosure. Although not illustrated, the treatment device 106 can include a slave motor 112 and a motor controller 118. The treatment device 106 can include a slave pressure system 110. The slave pressure system 110 is any suitable pressure system configured to increase and/or decrease the pressure in the treatment device 106. For example, the slave pressure system 110 can comprise the slave motor 112, the motor controller 118, and a pump. The motor controller 118 can activate the slave motor 112 to cause a pump or any other suitable device to inflate or deflate one or more sections 210 of the treatment device 106. The treatment device 106 can be operatively coupled to one or more slave processing devices. The one or more slave processing devices can be configured to execute instructions in accordance with aspects of this disclosure.

As illustrated in FIG. 2A, the treatment device 106 may comprise a brace 202 (e.g., a knee brace) configured to fit on the patient's body part, such as an arm, a wrist, a neck, a torso, a leg, a knee, an ankle, hips, or any other suitable body part. The brace 202 may include slave sensors 108. The slave sensors 108 can be configured to detect information associated with the patient. For example, the slave sensors 108 can detect a measured level of force exerted from the patient to the treatment device 106, a temperature of the one or more body parts in contact with the patient, a movement of the treatment device 106, any other suitable information, or any combination thereof. The brace 202 may include sections 210. The sections 210 can be formed as one or more chambers. The sections 210 may be configured to be filled with a liquid (e.g., a gel, air, water, etc.). The sections 210 may be configured in one or more shapes, such as, but not limited to rectangles, squares, diamonds circles, trapezoids, any other suitable shape, or combination thereof. The sections 210 may be the same or different sizes. The sections 210 may be positioned throughout the treatment device 106. The sections 210 can be positioned on the brace 202 above a knee portion, below the knee portion, and along the sides of the knee portion. In some embodiments, the brace 202 may include sections 210 positioned adjacent to each other and positioned throughout the brace 202. The sections 210 are not limited to the exemplary illustrations in FIG. 4. The brace 202 may include the one or more materials for the brace 202 and, in some embodiments, straps coupled to the brace 202. The brace 202 be formed from metal, foam, plastic, elastic, or any suitable material or combination of materials. The brace 202 may be formed in any suitable shape, size, or design.

As illustrated in FIG. 2B, the treatment device 106 may comprise a cap 204 that can be configured to fit onto the patient's head. FIG. 2B illustrates exemplary layers of the treatment device 106. The treatment device 106 may include a first layer 212 and a second layer 214. The first layer may be an outer later and the second layer 214 may be an inner layer. The second layer 214 may include the sections 210 and one or more sensors 108. In this example embodiment, the sections 210 are coupled to and/or from portions of the second layer 214. The sections 210 can be configured in a honeycomb pattern. The one or more sensors 108 may be coupled to the first layer 212. The first layer 212 can be coupled to the second layer 214. The first layer 212 can be designed to protect the sections 210 and the sensors 108. The cap 204 may include a strap. The cap 204 and/or the strap be formed from metal, foam, plastic, elastic, or any suitable material or combination of materials. The cap 204 may be formed in any suitable shape, size, or design.

As illustrated in FIG. 2C, the slave may comprise a mat 206. The mat 206 may be configured for a patient to lie or sit down, or to stand upon. The mat 206 may include one or more sensors 108. The mat 206 may include one or more sections 210. The sections 210 in the treatment device 106 can be configured in a square grid pattern. The one or more sensors 108 may be coupled to and/or positioned within the one or more sections 210. The mat 206 can be rectangular, circular, square, or any other suitable configuration. The mat 206 be formed from metal, foam, plastic, elastic, or any suitable material or combination of materials. The mat 206 may include one or more layers, such as a top layer.

As illustrated in FIG. 2D, the slave may comprise a wrap 208. The wrap 208 may be configured to wrap the wrap 208 around one or more portions and/or one or more body parts of the patient. For example, the wrap 208 may be configured to wrap around a person's torso. The wrap 208 may include one or more sensors 108. The wrap 208 may include one or more sections 210. The sections 210 in the treatment device 106 can be configured in a diamond grid pattern. The one or more sensors 108 may be coupled to and/or positioned within the one or more sections 210. The wrap 208 can be rectangular, circular, square, or any other suitable configuration. The wrap 208 may include a strap. The wrap 208 and/or the strap be formed from metal, foam, plastic, elastic, or any suitable material or combination of materials.

The treatment device 106 may include at least one or more motor controllers 118 and one or more motors 112, such as an electric motor. A pump, not illustrated, may be operatively coupled to the motor. The pump may be a hydraulic pump or any other suitable pump. The pump may be configured to increase or decrease pressure within the treatment device 106. The size and speed of the pump may determine the flow rate (i.e., the speed that the load moves) and the load at the slave motor 112 may determine the pressure in one or more sections 210 of the treatment device 106. The pump can be activated to increase or decrease pressure in the one or more sections 210. One or more of the sections 210 may include a sensor 108. The sensor 108 can be a sensor for detecting signals, such as a measured level of force, a temperature, or any other suitable signal. The motor controller 118 may be operatively coupled to the motor 112 and configured to provide commands to the motor 112 to control operation of the motor 112. The motor controller 118 may include any suitable microcontroller including a circuit board having one or more processing devices, one or more memory devices (e.g., read-only memory (ROM) and/or random access memory (RAM)), one or more network interface cards, and/or programmable input/output peripherals. The motor controller 118 may provide control signals or commands to drive the motor 112. The motor 112 may be powered to drive the pump of the treatment device 106. The motor 112 may provide the driving force to the pump to increase or decrease pressure at configurable speeds. Further, the treatment device 106 may include a current shunt to provide resistance to dissipate energy from the motor 112. In some embodiments, the treatment device 106 may comprise a haptic system, a pneumatic system, any other suitable system, or combination thereof. For example, the haptic system can include a virtual touch by applying forces, vibrations, or motions to the patient through the treatment device 106.

The slave computing device 102 may be communicatively connected to the treatment device 106 via a network interface card on the motor controller 118. The slave computing device 102 may transmit commands to the motor controller 118 to control the motor 112. The network interface card of the motor controller 118 may receive the commands and transmit the commands to the motor 112 to drive the motor 112. In this way, the slave computing device 102 is operatively coupled to the motor 112.

The slave computing device 102 and/or the motor controller 118 may be referred to as a control system (e.g., a slave control system) herein. The patient portal 114 may be referred to as a patient user interface of the control system. The control system may control the motor 112 to operate in a number of modes: standby, inflate, and deflate. The standby mode may refer to the motor 112 powering off so it does not provide a driving force to the one or more pumps. For example, if the pump does not receive instructions to inflate or deflate the treatment device 106, the motor 112 may remain turned off. In this mode, the treatment device 106 may not provide additional pressure to the patient's body part(s).

The inflate mode may refer to the motor 112 receiving manipulation instructions comprising measurements of pressure, causing the motor 112 to drive the one or more pumps coupled to the one or more sections of the treatment device 106 to inflate the one or more sections. The manipulation instruction may be configurable by the healthcare provider. For example, as the healthcare provider moves a master device 126, the movement is provided in a manipulation instruction for the motor 112 to drive the pump to inflate one or more sections of the treatment device 106. The manipulation instruction may include a pressure gradient to inflate first and second sections in a right side of a knee brace to first and second measured levels of force and inflate a third section in a left side of the knee brace to a third measured level of force. The first measured level of force correlates with the amount of pressure applied to the master device 126 by the healthcare provider's first finger. The second measured level of force correlates with the amount of pressure applied to the master device 126 by the healthcare provider's second finger. The third measured level of force correlates with the amount of pressure applied to the master device 126 by the healthcare provider's third finger.

The deflation mode may refer to the motor 112 receiving manipulation instructions comprising measurements of pressure, causing the motor 112 to drive the one or more pumps coupled to the one or more sections of the treatment device 106 to deflate the one or more sections. The manipulation instruction may be configurable by the healthcare provider. For example, as the healthcare provider moves the master device 126, the movement is provided in a manipulation instruction for the motor 112 to drive the pump to deflate one or more sections of the treatment device 106. The manipulation instruction may include a pressure gradient to deflate the first and second sections in the right side of the knee brace to fourth and fifth measured levels of force and deflate the third section in the left side of the knee brace to the third measured level of force. The fourth measured level of force correlates with the amount of pressure applied to the master device 126 by the healthcare provider's first finger. The fifth measured level of force correlates with the amount of pressure applied to the master device 126 by the healthcare provider's second finger. The sixth measured level of force correlates with the amount of pressure applied to the master device 126 by the healthcare provider's third finger. In this example, the healthcare provider loosened a grip (e.g., applied less pressure to each of the three fingers) applied to the treatment device 106 virtually via the master device 126.

During one or more of the modes, the one or more slave sensors 108 may measure force (i.e., pressure or weight) exerted by a part of the body of the patient. For example, the each of the one or more sections 310 of the treatment device 106 may contain any suitable sensor (e.g., strain gauge load cell, piezoelectric crystal, hydraulic load cell, etc.) for measuring force exerted on the treatment device 106. Further, the each of the one or more sections 310 of the treatment device 106 may contain any suitable sensor for detecting whether the body part of the patient separates from contact with the treatment device 106. The force detected may be transmitted via the network interface card of the treatment device 106 to the control system (e.g., slave computing device 102 and/or the slave controller 118). As described further below, the control system may modify a parameter of operating the slave motor 112 using the measured force. Further, the control system may perform one or more preventative actions (e.g., locking the slave motor 112 to stop the pump from activating, slowing down the slave motor 112, presenting a notification to the patient such as via the patient portal 114, etc.) when the body part is detected as separated from the treatment device 106, among other things.

In some embodiments, the remote examination system 100 includes the imaging device 116. The imaging device 116 may be configured to capture and/or measure angles of extension and/or bend of body parts and transmit the measured angles to the slave computing device 102 and/or the master computing device 122. The imaging device 116 may be included in an electronic device that includes the one or more processing devices, memory devices, and/or network interface cards. The imaging device 116 may be disposed in a cavity of the treatment device 106 (e.g., in a mechanical brace). The cavity of the mechanical brace may be located near a center of the mechanical brace such that the mechanical brace affords to bend and extend. The mechanical brace may be configured to secure to an upper body part (e.g., leg, arm, etc.) and a lower body part (e.g., leg, arm, etc.) to measure the angles of bend as the body parts are extended away from one another or retracted closer to one another.

The imaging device 116 can be a wearable, such as a wristband 704. The wristband 704 may include a 2-axis accelerometer to track motion in the X, Y, and Z directions, an altimeter for measuring altitude, and/or a gyroscope to measure orientation and rotation. The accelerometer, altimeter, and/or gyroscope may be operatively coupled to a processing device in the wristband 704 and may transmit data to the processing device. The processing device may cause a network interface card to transmit the data to the slave computing device 102 and the slave computing device 102 may use the data representing acceleration, frequency, duration, intensity, and patterns of movement to track measurements taken by the patient over certain time periods (e.g., days, weeks, etc.). Executing a clinical portal 134, the slave computing device 102 may transmit the measurements to the master computing device 122. Additionally, in some embodiments, the processing device of the wristband 704 may determine the measurements taken and transmit the measurements to the slave computing device 102. In some embodiments, the wristband 704 may use photoplethysmography (PPG), which detects an amount of red light or green light on the skin of the wrist, to measure heart rate. For example, blood may absorb green light so that when the heart beats, the blood flow may absorb more green light, thereby enabling the detection of heart rate. The heart rate may be sent to the slave computing device 102 and/or the master computing device 122.

The slave computing device 102 may present the measurements (e.g., measured level of force or temperature) of the body part of the patient taken by the treatment device 106 and/or the heart rate of the patient via a graphical indicator (e.g., a graphical element) on the patient portal 114, as discussed further below. The slave computing device 102 may also use the measurements and/or the heart rate to control a parameter of operating the treatment device 106. For example, if the measured level of force exceeds a target pressure level for an examination session, the slave computing device 102 may control the motor 112 to reduce the pressure being applied to the treatment device 106.

In some embodiments, the remote examination system 100 may include a master computing device 122 communicatively coupled to a master console 124. The master console 124 can include a master device 126. The master device 126 can include a master sensor 128 and a master pressure system 130. The master pressure system can include a master motor 132. The remote examination system may also be communicatively coupled to a master display 136. Each of the master computing device 122, the master device 126, and the master display 136 may include one or more processing devices, memory devices, and network interface cards. The network interface cards may enable communication via a wireless protocol for transmitting data over short distances, such as Bluetooth, ZigBee, Near-Field Communications (NFC), etc. In some embodiments, the master computing device 122 is communicatively coupled to the master device 126 and the master display 136 via Bluetooth.

Additionally, the network interface cards may enable communicating data over long distances, and in one example, the master computing device 122 may communicate with a network 104. The master computing device 122 may be communicatively coupled with the slave computing device 102 and the cloud-based computing system 142.

The master computing device 122 may be any suitable computing device, such as a laptop, tablet, smartphone, or computer. The master computing device 122 may include a display capable of presenting a user interface, such as a clinical portal 134. The clinical portal 134 may be implemented in computer instructions stored on the one or more memory devices of the master computing device 122 and executable by the one or more processing devices of the master computing device 122. The clinical portal 134 may present various screens to a user (e.g., a healthcare provider), the screens configured to enable the user to view a patient's medical records, a treatment plan, or progress during the treatment plan; to initiate a remote examination session; to control parameters of the master device 126; to view progress of rehabilitation during the remote examination session, or combination thereof. The master computing device 122 may also include instructions stored on the one or more memory devices that, when executed by the one or more processing devices of the master computing device 122, perform operations to control the master device 126.

The master computing device 122 may execute the clinical portal 134. The clinical portal 134 may be implemented in computer instructions stored on the one or more memory devices of the master computing device 122 and executable by the one or more processing devices of the master computing device 122. The clinical portal 134 may present various screens to a healthcare provider (e.g., a clinician), the screens configured to enables the clinician to view a remote examination of a patient, such as a patient rehabilitating from a surgery (e.g., knee replacement surgery) or from an injury (e.g., sprained ankle). During a telemedicine session, an augmented image representing one or more body parts of the patient may be presented simultaneously with a video of the patient on the clinical portal 134 in real-time or in near real-time. For example, the clinical portal 134 may, at the same time, present the augmented image 402 of the knee of the patient and portions of the patient's leg extending from the knee and a video of the patient's upper body (e.g., face), so the healthcare provider can engage in more personal communication with the patient (e.g., via a video call). The video may be of the patient's full body, such that, during the telemedicine session, the healthcare provider may view the patient's entire body. The augmented image 402 can be displayed next to the video and/or overlaid onto the respective one or more body parts of the patient. For example, the augmented image 402 may comprise a representation of the treatment device 106 coupled to the patient's knee and leg portions. The clinical portal 134 may display the representation of the treatment device 106 overlaid onto the respective one or more body parts of the patient. Real-time may refer to less than 2 seconds, or any other suitable amount of time. Near real-time may refer to 2 or more seconds. The video may also be accompanied by audio, text, and other multimedia information. The master display 136 may also be configured to present the augmented image and/or the video as described herein.

Presenting the remote examination generated by the artificial intelligence engine concurrently with a presentation of the patient video may provide an enhanced user interface because the healthcare provider, while reviewing the examination on the same user interface, may also continue to visually and/or otherwise communicate with the patient. The enhanced user interface may improve the healthcare provider's experience in using the computing device and may encourage the healthcare provider to reuse the user interface. Such a technique may also reduce computing resources (e.g., processing, memory, network), because the healthcare provider does not have to switch to another user interface screen and, using the characteristics of the patient, enter a query for examination guidelines to recommend. For example, the enhanced user interface may provide the healthcare provider with recommended procedures to conduct during the telemedicine session. The recommended procedures may comprise a guide map, including indicators of locations and measured amounts of pressure to apply on the patient's one or more body parts. The artificial intelligence engine may analyze the examination results (e.g., measured levels of force exerted to and by the patient's one or more body parts, the temperature of the patient, the pain level of the patient, a measured range of motion of the one or more body parts, etc.) and provide, dynamically on the fly, the optimal examination procedures and excluded examination procedures.

The clinical portal 134 may also provide examination information generated during the telemedicine session for the healthcare provider to view. The examination information can include a summary of the examination and/or the results of the examination in real-time or near real-time, such as measured properties of the patient during the examination. Examples of the measured properties may include, but are not limited to, angles of bend/extension, pressure exerted on the master device 126, pressure exerted by the patient on the treatment device 106, images of the examined/treated body part, and vital signs of the patient, such as heart rate and temperature. The clinical portal 134 may also provide the clinician's notes and the patient's health information, such as a health history, a treatment plan, and a progress of the patient throughout the treatment plan. So the healthcare provider may begin the remote examination, the examination information specific to the patient may be transmitted via the network 104 to the cloud-based computing system 142 for storage and/or to the master computing device 122.

In some embodiments, the clinical portal 134 may include a treatment plan that includes one or more examination procedures (e.g., manipulation instructions to manipulate one or more sections 210 of the treatment device 106). For example, a healthcare provider may input, to the clinical portal 134, a treatment plan with pre-determined manipulation instructions for the treatment device 106 to perform during the remote examination. The healthcare provider may input the pre-determined manipulation instructions prior the remote examination. The treatment device 106 can be activated to perform the manipulations in accordance with the pre-determined manipulation instructions. The healthcare provider may observe the remote examination in real-time and make modifications to the pre-determined manipulation instructions during the remote examination. Additionally, the system 100 can store the results of the examination and the healthcare provider can complete the examination using the stored results (e.g., stored slave sensor data) and the master device 126. In other words, the master processing device can use the slave sensor data to manipulate the master device 126. This manipulation of the master device 126 can allow the healthcare provider to virtually feel the patient's one or more body parts and provide the healthcare provider with additional information to determine a personalized treatment plan for the patient.

The master device 126 may be an examination device configured for control by a healthcare provider. The master device 126 may be a joystick, a model treatment device (e.g., a knee brace to fit over a manikin knee), an examination device to fit over a body part of the healthcare provider (e.g., a glove device), any other suitable device, or combination thereof. The joystick may be configured to be used by a healthcare provider to provide manipulation instructions. The joystick may have one or more buttons (e.g., a trigger) to apply more or less pressure to one or more sections of the treatment device 106. The joystick may be configured to control a moveable indicator (e.g., a cursor) displayed at the master display or any other suitable display. The moveable indicator can be moved over an augmented image 400 of the treatment device 106 and/or one or more body parts of the patient. The healthcare provider may be able to provide verbal commands to increase and/or decrease pressure based on where the moveable indicator is positioned relative to the augmented image 400. The joystick may have master sensors 128 within a stick of the joystick. The stick may be configured to provide feedback to the user (e.g., vibrations or pressure exerted by the stick to the user's hand).

The model of the treatment device may be formed similarly to the treatment device 106. For example, if the treatment device 106 is the knee brace 202, the master device can be a model knee brace with similar characteristics of the knee brace 202. The model can be configured for coupling to a manikin or any other suitable device. The model can comprise the master pressure system 130 and master sensors 128 and function as described in this disclosure. The model may be configured for a healthcare provider to manipulate (e.g., touch, move, and/or apply pressure) to one or more sections of the model and to generate master sensor data based on such manipulations.

The model can be operatively coupled to the treatment device 106. The master sensor data can be used to inflate and/or deflate one or more corresponding sections of the treatment device 106 (e.g., as the healthcare provider is manipulating the model, the treatment device 106 is being manipulated on the patient). Responsive to receiving the slave sensor data, the master pressure system 130 can active and inflate and/or deflate one or more sections of the model (e.g., the pressure applied to the treatment device 106 by the patient's one or more body parts is similarly applied to the model for the healthcare provider to examine). The healthcare provider can essentially feel, with his or her bare (or appropriately gloved) hands, the patient's one or more body parts (e.g., the knee) while the healthcare provider virtually manipulates the patient body part(s).

In some embodiments, the system 100 may include one or more master computing devices 122 and one or more master consoles 124. For example, a second master console can include a second master device 126 operatively coupled to a second master computing device. The second master device can comprise a second master pressure system 130, and, using the slave force measurements, the one or more processing devices of system 100 can be configured to activate the second master pressure system 130. During and/or after a telemedicine session, one or more healthcare providers can manipulate the treatment device 106 and/or use the slave sensor data to virtually feel the one or more body parts of the patient. For example, a physician and a physical therapist may virtually feel the one or more body parts of the patient at the same time or at different times. The physician may provide the manipulation instructions and the physical therapist may observe (e.g., virtually see and/or feel) how the patient's one or more body parts respond to the manipulations. The physician and the physical therapist may use different examination techniques (e.g., locations of the manipulations and/or measure levels of force applied to the treatment device 106) to obtain information for providing a treatment plan for the patient. Resulting from the physician using the master device 106 and the physical therapist using the second master device, each can provide manipulation instructions to the treatment device 106. The manipulation instructions from the master device 106 and the second master device may be provided at the same time or at a different time (e.g., the physician provides a first manipulation instruction via the master device 126 and the physical therapist provides a second manipulation instruction via the second master device). In another example, the physician may have input a pre-determined manipulation instruction for the remote examination and the physical therapist may use the second master device to adjust the pre-determined manipulation instructions. The physician and the physical therapist may be located remotely from each other (and remotely from the patient) and each can use the system 100 to examine the patient and provide a personalized treatment plan for the patient. The system 100 can allow for collaboration between one or more healthcare providers and provide the healthcare providers with information to make optimal adjustments to the patient's treatment plan.

As illustrated in FIG. 3, the master device 126 comprises a glove device 300 configured to fit on a healthcare provider's hand. The glove device 300 can include fingers 302. The glove may include one or more sensors (e.g., one or more master sensors 128). The glove device 300 may include the master sensors 128 positioned along the fingers 302, 304, 306, 308, 310 (collectively, fingers 302), throughout the palm of the glove, in any other suitable location, or in any combination thereof. For example, each finger can include a series of master sensors 128 positioned along the fingers 302. Each of the series of master sensors 128 can be operatively coupled to one or more master controllers 138. The master device 126 may include at least one or more master controllers 138 and one or more master motors 132, such as an electric motor (not illustrated).

A pump (not illustrated) may be operatively coupled to the motor. The pump may be configured to increase or decrease pressure within the master device 126. The master device 126 may include one or more sections and the pump can be activated to increase or decrease pressure (e.g., inflating or deflating fluid, such as water, gel, air) in the one or more sections (e.g., one or more fingertips). One or more of the sections may include a master sensor 128. The master sensor 128 can be a sensor for detecting signals, such as pressure, or any other suitable signal. The master controller 138 may be operatively coupled to the master motor 132 and configured to provide commands to the master motor 132 to control operation of the master motor 132. The master controller 138 may include any suitable microcontroller including a circuit board having one or more processing devices, one or more memory devices (e.g., read-only memory (ROM) and/or random access memory (RAM)), one or more network interface cards, and/or programmable input/output peripherals. The master controller 138 may provide control signals or commands to drive the master motor 132. The master motor 132 may be powered to drive the pump of the master device 126. The master motor 132 may provide the driving force to the pump to increase or decrease pressure at configurable speeds. Further, the master device 126 may include a current shunt to provide resistance to dissipate energy from the master motor 132. In some embodiments, the treatment device 106 may comprise a haptic system, a pneumatic system, any other suitable system, or combination thereof. For example, the haptic system can include a virtual touch by applying forces, vibrations, or motions to the healthcare provider through the master device 126.

The master computing device 122 may be communicatively connected to the master device 126 via a network interface card on the master controller 138. The master computing device 122 may transmit commands to the master controller 138 to control the master motor 132. The network interface card of the master controller 138 may receive the commands and transmit the commands to the master controller 138 to drive the master motor 132. In this way, the master computing device 122 is operatively coupled to the master motor 132.

The master computing device 122 and/or the master controller 138 may be referred to as a control system (e.g., a master control system) herein. The clinical portal 134 may be referred to as a clinical user interface of the control system. The master control system may control the master motor 132 to operate in a number of modes, including: standby, inflate, and deflate. The standby mode may refer to the master motor 132 powering off so that it does not provide any driving force to the one or more pumps. For example, when the healthcare provider is not touching an augmented image of the treatment device 106, the pump of the master device 126 may not receive instructions to inflate or deflate one or more sections of the master device 126 and the master motor 132 may remain turned off. In the standby mode, the master device 126 may not apply pressure to the healthcare provider's body part(s) (e.g., to the healthcare provider's finger 304 via the glove device 300) because the healthcare provider is not in virtual contact with the treatment device 106. Furthermore, in standby mode, the master device 126 may not transmit the master sensor data based on manipulations of the master device 126 (e.g., pressure virtually exerted from the healthcare care provider's hand to the master device 126) to the patient via the treatment device 106.

The inflate mode may refer to the master motor 132 receiving slave sensor data comprising measurements of pressure, causing the master motor 132 to drive the one or more pumps coupled to the one or more sections of the master device 126 (e.g., one or more fingers 302, 304, 406, 308, 310) to inflate the one or more sections. The slave sensor data may be provided by the one or more slave sensors 108 of the treatment device 106 via the slave computing device 102. For example, as the healthcare provider manipulates (e.g., moves) the master device 126 to virtually contact one or more body parts of the patient using the treatment device 106 in contact with the patient's one or more body parts, the treatment device 106 is manipulated. The slave sensors 108 are configured to detect the manipulation of the treatment device 106. The detected information may include how the patient's one or more body parts respond to the manipulation. The one or more slave sensors 108 may detect that one area of the patient's body part exerts a first measured level of force and that another area of the patient's body part exerts a second measured level of force (e.g., the one area may be swollen or inconsistent with baseline measurements or expectations as compared to the other area). The master computing device 122 can receive the information from the slave sensor data and instruct the master motor 132 to drive the pump to inflate one or more sections of the master device 126. The level of inflation of the one or more sections of the master device 126 may correlate with one or more measured levels of force detected by the treatment device 106. The slave sensor data may include a pressure gradient. The master computing device 122 may instruct the master pressure system 130 to inflate a first section (e.g., the fingertips of the first finger 302) associated with the first measured level of force exerted from a left side of the knee brace 202. The master computing device 122 may instruct the master pressure system 130 to inflate second and third sections (e.g., the fingertips of second and third fingers 304, 306) associated with second and third measured levels of force exerted from a front side of the knee brace 202. In other words, in response to the master device 126 virtually touching the treatment device 106, the first measured level of force may correlate with the amount of pressure applied to the healthcare provider's first finger through the first finger 302 of the master device 126. Similarly, the second measured level of force may correlate with the amount of measured force applied by the healthcare provider's second finger through the second finger 304 of the master device 126. The third measured level of force may correlate with the amount of measured force applied by the healthcare provider's third finger through the third finger 306 of the master device 126. The glove device 300 can include a fourth finger 308 to provide a fourth measured level of force, a fifth finger 310 to provide a fifth measured level of force, and/or other sections, such as a palm, or any combination thereof configured to provide measured levels of force to the healthcare provider. The sections of the glove device 300 can be inflated or deflated to correlate with the same and/or different levels of measured force exerted on the treatment device 106.

The deflation mode may refer to the master motor 132 receiving slave sensor data comprising measurements of pressure, causing the master motor 132 to drive the one or more pumps coupled to the one or more sections of the master device 126 (e.g., one or more fingers 302) to deflate the one or more sections. The deflation mode of the master pressure system 130 can function similarly as the inflation mode; however, in the deflation mode, the master pressure system 130 deflates, rather than inflates, the one or more sections of the master device 126. For example, the one or more slave sensors 108 may detect that one area of the patient's body part exerts a first measured level of force and that another area of the patient's body part exerts a second measured level of force (e.g., the one area may be less swollen or less inconsistent with baseline measurements or expectations as compared to the other area). The master computing device 122 can receive the information from the slave sensor data and instruct the master motor 132 to drive the pump to deflate one or more sections of the master device 126. The level of deflation of the one or more sections of the master device 126 may correlate with one or more measured levels of force detected by the treatment device 106.

The measured levels of force can be transmitted between the treatment device 106 and the master device 126 in real-time, near real-time, and/or at a later time. In other words, the healthcare provider can use the master device 126 to virtually examine the patient's body part using the healthcare provider's hand and feel the patient's body part (e.g., the pressure, etc.). Similarly, the patient can feel the healthcare provider virtually touching his or her body part (e.g., from the pressure exerted by the treatment device 106). During the telemedicine session, the patient, via the patient portal 114, can communicate to the healthcare provider via the clinical portal 134. For example, during the remote examination, the patient can inform the healthcare provider that the location of the body part that the healthcare provider is virtually touching (e.g., manipulating), is painful. The information can be communicated verbally and/or visually (e.g., input into the patient portal 114 directly by the client and transmitted to the clinical portal 134 and/or the master display 136). The healthcare provider can receive additional information, such as temperature of the patient's body part, vital signs of the patient, any other suitable information, or any combination thereof.

During one or more of the inflation and deflation modes, the one or more master sensors 128 may measure force (i.e., pressure) exerted by the healthcare provider via the master device 126. For example, one or more sections of the master device 126 may contain any suitable sensor (e.g., strain gauge load cell, piezoelectric crystal, hydraulic load cell, etc.) for measuring force exerted on the master device 126. Further, each section 310 of the master device 126 may contain any suitable sensor for detecting whether the body part of the healthcare provider separates from contact with the master device 126. The measured level(s) of force detected may be transmitted via the network interface card of the master device 126 to the control system (e.g., master computing device 122 and/or the master controller 138). As described further below, using the measured level(s) of force, the control system may modify a parameter of operating the master motor 132. Further, the control system may perform one or more preventative actions (e.g., locking the master motor 132 to stop the pump from activating, slowing down the master motor 132, or presenting a notification to the healthcare provider (such as via the clinical portal 134, etc.)) when the body part is detected as being separated from the master device 126, among other things.

In some embodiments, the remote examination system 100 includes the master display 136. The master console 124 and/or the clinical portal 134 may comprise the master display 136. The master display 136 may be configured to display the treatment device 106 and/or one or more body parts of a patient. For example, the slave computing device 102 may be operatively coupled to an imaging device 116 (e.g., a camera or any other suitable audiovisual device) and/or other sensorial or perceptive (e.g., tactile, gustatory, haptic, pressure-sensing-based or electromagnetic (e.g., neurostimulation) communication devices. Any reference herein to any particular sensorial modality shall be understood to include and to disclose by implication a different one or more sensory modalities. The slave computing device 102 can transmit, via the network 104, real images and/or a real live-streaming video of the treatment device 106 and/or the patient, to the master display 136. The real images and/or real video may include angles of extension and/or bend of body parts of the patient, or any other suitable characteristics of the patient. The treatment device 106 may be operatively coupled to a medical device, such as a goniometer 702. The goniometer 702 may detect angles of extension and/or bend of body parts of the patient and transmit the measured angles to the slave computing device 102 and/or the treatment device 106. The slave computing device 102 can transmit the measured angles to the master computing device 122, to the master display 136, or any other suitable device. The master display 136 can display the measured angles in numerical format, as an overlay image on the image of the treatment device 106 and/or the patient's one or more body parts, any other suitable format, or combination thereof. For example, as illustrated in FIG. 4A, body parts (e.g., a leg and a knee) are extended at a first angle. In FIG. 4B, the body parts are illustrated as being extended at a second angle. The master display 136 may be included in an electronic device that includes the one or more processing devices, memory devices, and/or network interface cards.

Depending on what result is desired, the master computing device 122 and/or a training engine 146 may be trained to output a guide map. The guide map may be overlaid on the augmented image 400. The guide map may include one or more indicators. To guide the master device 126, the indicators can be positioned over one or more sections 310 of the augmented image 400 of the treatment device 106. For example, the augmented image 402 may include a first indicator (e.g., dotted lines in the shape of a fingertip) positioned over a top portion of patient's knee and a second indicator positioned over a left side of the patient's knee. The first indicator is a guide for the healthcare provider to place the first finger 302 on the first indicator and the second finger 304 on the second indicator. The guide map may comprise a pressure gradient map. The pressure gradient map can include the current measured levels of force at the location of the indicator and/or a desired measured level of force at the location of the indicator. For example, the first indicator may comprise a first color, a first size, or any other suitable characteristic to indicate a first measured level of force. The second indicator may comprise a second color, a second size, or any other suitable characteristic to indicate a second measured level of force. When the master device 126 reaches the desired measured levels of force, an alert may be provided. The alert may be a visual, audio and/or another alert. For example, the alert may comprise the indicator changing colors when the measured level of force is provided. The guide map may include one or more configurations using characteristics of the injury, the patient, the treatment plan, the recovery results, the examination results, any other suitable factors, or combination thereof. One or more configurations may be displayed during the remote examination portion of a telemedicine session.

The master computing device 122 and/or the training engine 146 may include one or more thresholds, such as pressure thresholds. The one or more pressure thresholds may be based on characteristics of the injury, the patient, the treatment plan, the recovery results, the examination results, the pain level, any other suitable factors, or combination thereof. For example, one pressure threshold pertaining to the pain level of the patient may include a pressure threshold level for the slave pressure system 110 not to inflate a particular section 210 more than a first measured level of force. As the pain level of the patient decreases, the pressure threshold may change such that a second measured level of force may be applied to that particular section 210. In this case, the patient's decreased pain level may, for more optimal examination results (e.g., the second measured level of force is greater than the first measured level of force), allow for the healthcare provider to increase the measured amount of pressure applied to the patient's body part. Similarly, the master computing device 122 and/or the training engine 146 may be configured to adjust any pre-determined manipulation instructions. In this way, the manipulation instructions can be adapted to the specific patient.

In other embodiments, the master display 136 can display an augmented image (e.g., exemplary augmented images 400 illustrated in FIG. 4), an augmented live-streaming video, a holographic image, any other suitable transmission, or any combination thereof of the treatment device 106 and/or one or more body parts of the patient. For example, the master display 136 may project an augmented image 402 representing the treatment device 106 (e.g., a knee brace 202). The augmented image 402 can include a representation 410 of the knee brace 202. The augmented image 402 can include a representation 412 of one or more body parts of a patient. Using the master device 126, the healthcare provider can place a hand on the image and manipulate the image (e.g., apply pressure virtually to one or more sections of the patient's knee via the treatment device 106. The one or more processing devices may cause a network interface card to transmit the data to the master computing device 122 and the master computing device 122 may use the data representing pressure, temperature, and patterns of movement to track measurements taken by the patient's recovery over certain time periods (e.g., days, weeks, etc.). In FIG. 4, the augmented images 400 are two dimensional, but the augmented images 400 may be transmitted as three-dimensional images or as any other suitable image dimensionality.

The master display 136 can be configured to display information obtained from a wearable, such as the wristband 704. The information may include motion measurements of the treatment device 106 in the X, Y, and Z directions, altitude measurements, orientation measurements, rotation measurements, any other suitable measurements, or combination thereof. The wristband 704 may be operatively coupled to an accelerometer, an altimeter, and/or a gyroscope. The accelerometer, the altimeter, and/or the gyroscope may be operatively coupled to a processing device in the wristband 704 and may transmit data to the one or more processing devices. The one or more processing devices may cause a network interface card to transmit the data to the master computing device 122 and the master computing device 122 may use the data representing acceleration, frequency, duration, intensity, and patterns of movement to track measurements taken by the patient over certain time periods (e.g., days, weeks, etc.). Executing the clinical portal 134, the master computing device 122 may transmit the measurements to the master display 136. Additionally, in some embodiments, the processing device of the wristband 704 may determine the measurements taken and transmit the measurements to the slave computing device 102. The measurements may be displayed on the patient portal 114. In some embodiments, the wristband 704 may measure heart rate by using photoplethysmography (PPG), which detects an amount of red light or green light on the skin of the wrist. For example, blood may absorb green light so when the heart beats, the blood volume flow may absorb more green light, thereby enabling heart rate detection. In some embodiments, the wristband 704 may be configured to detect temperature of the patient. The heart rate, temperature, any other suitable measurement, or any combination thereof may be sent to the master computing device 122.

The master computing device 122 may present the measurements (e.g., pressure or temperature) of the body part of the patient taken by the treatment device 106 and/or the heart rate of the patient via a graphical indicator (e.g., a graphical element) on the clinical portal 134. The measurements may be presented as a gradient map, such as a pressure gradient map or a temperature gradient map. The map may be overlaid over the image of the treatment device 106 and/or the image of the patient's body part. For example, FIG. 4C illustrates an exemplary augmented image 406 displaying a pressure gradient 414 over the image of the patient's body parts 412 (e.g., feet). FIG. 4D illustrates an exemplary augmented image 408 displaying a temperature gradient 416 over the image of the patient's body parts 412 (e.g., feet).

Referring back to FIG. 1, the remote examination system 100 may include a cloud-based computing system 142. In some embodiments, the cloud-based computing system 142 may include one or more servers 144 that form a distributed computing architecture. Each of the servers 144 may include one or more processing devices, memory devices, data storage devices, and/or network interface cards. The servers 144 may be in communication with one another via any suitable communication protocol. The servers 144 may store profiles for each of the users (e.g., patients) configured to use the treatment device 106. The profiles may include information about the users such as a treatment plan, the affected body part, any procedure the user had had performed on the affected body part, health, age, race, measured data from the imaging device 116, slave sensor data, measured data from the wristband 704, measured data from the goniometer 702, user input received at the patient portal 114 during the telemedicine session, a level of discomfort the user experienced before and after the remote examination, before and after remote examination images of the affected body part(s), and so forth.

In some embodiments, the cloud-based computing system 142 may include a training engine 146 capable of generating one or more machine learning models 148. The machine learning models 148 may be trained to generate treatment plans, procedures for the remote examination, or any other suitable medical procedure for the patient in response to receiving various inputs (e.g., a procedure via a remote examination performed on the patient, an affected body part the procedure was performed on, other health characteristics (age, race, fitness level, etc.)). The one or more machine learning models 148 may be generated by the training engine 146 and may be implemented in computer instructions executable by one or more processing devices of the training engine 146 and/or the servers 144.

To generate the one or more machine learning models 148, the training engine 146 may train the one or more machine learning models 148. The training engine 146 may use a base data set of patient characteristics, results of remote examination(s), treatment plans followed by the patient, and results of the treatment plan followed by the patients. The results may include information indicating whether the remote examination led to an identification of the affected body part and whether the identification led to a partial recovery of the affected body part or lack of recovery of the affected body part. The results may include information indicating the measured levels of force applied to the one or more sections of the treatment device 106.

The training engine 146 may be a rackmount server, a router computer, a personal computer, an Internet of Things (IoT) device, a portable digital assistant, a smartphone, a laptop computer, a tablet computer, a camera, a video camera, a netbook, a desktop computer, a media center, any other desired computing device, or any combination of the above. The training engine 146 may be cloud-based or a real-time software platform, and it may include privacy software or protocols, and/or security software or protocols.

The one or more machine learning models 148 may also be trained to translate characteristics of patients received in real-time (e.g., from an electronic medical records (EMR) system, from the slave sensor data, etc.). The one or more machine learning models 148 may refer to model artifacts that are created by the training engine 146 using training data that includes training inputs and corresponding target outputs. The training engine 146 may find patterns in the training data that map the training input to the target output, and generate the machine learning models 148 that capture these patterns. Although depicted separately from the slave computing device 102, in some embodiments, the training engine 146 and/or the machine learning models 148 may reside on the slave computing device 102 and/or the master computing device 122.

Different machine learning models 148 may be trained to recommend different optimal examination procedures for different desired results. For example, one machine learning model may be trained to recommend optimal pressure maps for most effective examination of a patient, while another machine learning model may be trained to recommend optimal pressure maps using the current pain level and/or pain level tolerance of a patient.

The machine learning models 148 may include one or more of a neural network, such as an image classifier, recurrent neural network, convolutional network, generative adversarial network, a fully connected neural network, or some combination thereof, for example. In some embodiments, the machine learning models 148 may be composed of a single level of linear or non-linear operations or may include multiple levels of non-linear operations. For example, the machine learning model may include numerous layers and/or hidden layers that perform calculations (e.g., dot products) using various neurons.

FIGS. 1-4 are not intended to be limiting: the remote examination system 100 may include more or fewer components than those illustrated in FIGS. 1-4.

FIG. 5 illustrates a computer-implemented method 500 for remote examination. The method 500 may be performed by the remote examination system 100, such as at a master processing device. The processing device is described in more detail in FIG. 6. The steps of the method 500 may be stored in a non-transient computer-readable storage medium.

At step 502, the method 500 includes the master processing device receiving slave sensor data from one or more slave sensors 108. The master processing device may receive, via the network 104, the slave sensor data from a slave processing device.

At step 504, the master processing device can transmit an augmented image 400. The augmented image 400 may be based on the slave sensor data.

At step 506, the master processing device receives master sensor data associated with a manipulation of the master device 126. For example, the master sensor data may include a measured level of force that the user, such as a healthcare provider, applied to the master device 126.

At step 508, the master processing device can generate a manipulation instruction. The manipulation instruction is based on the master sensor data associated with the manipulation of the master device 126.

At step 510, the master processing device transmits the manipulation instruction. The master processing device may transmit, via the network 104, the manipulation instruction to the slave computing device 102.

At step 512, the master processing device causes the slave pressure system to activate. Using the manipulation instruction, the slave computing device 102 can cause the treatment device 106 to activate the slave pressure system 110. For example, responsive to the manipulation instruction (e.g., to increase and/or decrease one or more measured levels of force in one or more sections of the treatment device), the slave pressure system 110 can cause the slave controller 118 to activate the slave motor 112 to inflate and/or deflate the one or more sections 210 to one or more measured levels of force.

At step 514, the master processing device receives slave force measurements. The slave force measurements can include one or more measurements associated with one or more measured levels of force that the patient's body is applying to the treatment device 106.

At step 516, the master processing device uses the pressure slave measurements to activate the master pressure system 130. For example, the master pressure system 130 can cause the master device 126 to inflate and/or deflate one or more sections 310 of the master device 126 such that the measured levels of force of the one or more sections 310 directly correlate with the one or more measured levels of force that the patient's body is applying to the one or more sections 210 of the treatment device 106.

FIG. 6 illustrates a computer-implemented method 600 for remote examination. The method 600 may be performed by the remote examination system 100, such as at a slave processing device. The processing device is described in more detail in FIG. 6. The steps of the method 600 may be stored in a non-transient computer-readable storage medium.

At step 602, the method 600 includes the slave processing device receiving slave sensor data from one or more slave sensors 108. The one or more slave sensors 108 may include one or more measured levels of force that the patient's body is applying to the treatment device 106.

At step 604, the slave processing device transmits the slave sensor data. The slave processing device may transmit, via the network 104, the slave sensor data to the master computing device 122.

At step 606, the slave processing device may transmit an augmented image 400. The augmented image 400 is based on the slave sensor data. For example, the augmented image 400 may include a representation of the treatment device 106, one or more body parts of the patient, measured levels of force, measured levels of temperature, any other suitable information, or combination thereof.

At step 608, the slave processing device receives a manipulation instruction. The manipulation instruction can be generated based on the master sensor data.

At step 610, using the manipulation instruction, the slave processing device activates the slave pressure system 110. For example, the manipulation instruction may cause the slave pressure system 110 to inflate and/or deflate one or more sections 210 of the treatment device 106 to correlate with one or more levels of force applied to one or more sections 310 of the master device 126.

At step 612, the slave processing device receives slave force measurements. The slave force measurements can include one or more measured levels of force exerted by the patient's body to the treatment device 106.

At step 614, the slave processing device transmits the slave force measurements, such as to the master processing device.

At step 616, using the slave force measurements, the slave processing device causes a master pressure system 130 to activate. For example, the master pressure system 130 can cause the master device 126 to inflate and/or deflate one or more sections 310 of the master device 126 such that the measured levels of force of the one or more sections 310 correlate with the one or more measured levels of force that the patient's body is applying to the one or more sections 210 of the treatment device 106.

FIGS. 5-6 are not intended to be limiting: the methods 500, 600 can include more or fewer steps and/or processes than those illustrated in FIGS. 5-6. Further, the order of the steps of the methods 500, 600 is not intended to be limiting; the steps can be arranged in any suitable order. Any or all of the steps of methods 500, 600 may be implemented during a telemedicine session or at any other desired time.

FIG. 7 illustrates a high-level component diagram of an illustrative architecture of system 700 for enabling remote adjustment of a device, such as during a telemedicine session, according to certain aspects of this disclosure. The system 700 may include one or more components of FIG. 1 that have been described above. Any component or combination of the components illustrated in the system 700 may be included in and/or used in connection with the examination system 100. The system 100 and/or the system 700 is not limited to use in the medical field.

In some embodiments, the system 700 may include a slave computing device 102 communicatively coupled to a treatment device 800, such as an electromechanical device 802, a goniometer 702, a wristband 810, and/or pedals 810 of the electromechanical device 802. Each of the computing device 102, the electromechanical device 802, the goniometer 702, the wristband 810, and the pedals 810 may include one or more processing devices, memory devices, and network interface cards. The network interface cards may enable communication via a wireless protocol for transmitting data over short distances, such as Bluetooth, ZigBee, etc. In some embodiments, the computing device 102 is communicatively coupled to the electromechanical device 802, goniometer 702, the wristband 810, and/or the pedals 810 via Bluetooth.

The patient portal 114 may present various screens to a user that enable the user to view a treatment plan, initiate a pedaling session of the treatment plan, control parameters of the electromechanical device 802, view progress of rehabilitation during the pedaling session, and so forth as described in more detail below. The computing device 102 may also include instructions stored on the one or more memory devices that, when executed by the one or more processing devices of the computing device 102, perform operations to control the electromechanical device 802.

The clinical portal 134 may present various screens to a healthcare provider, such as a physician that enable the physician to create a treatment plan for a patient, view progress of the user throughout the treatment plan, view measured properties (e.g., angles of bend/extension, force exerted on pedals 810, heart rate, steps taken, images of the affected body part) of the user during sessions of the treatment plan, view properties (e.g., modes completed, revolutions per minute, etc.) of the electromechanical device 802 during sessions of the treatment plan. The treatment plan specific to a patient may be transmitted via the network 104 to the cloud-based computing system 142 for storage and/or to the computing device 102 so the patient may begin the treatment plan. The healthcare provider can adjust the treatment plan during a session of the treatment plan in real-time or near real-time. For example, the healthcare provider may be monitoring the patient while the patient is using the electromechanical device 802 and, by using the measured properties, the healthcare provider may adjust the treatment plan and transmit the adjusted treatment plan to control at least one operation of the electromechanical device 802. The treatment plan and/or an adjusted treatment plan can include parameters for operation of the electromechanical device 802. If the patient is operating the electromechanical device 802 such that the operations are not within the parameters, a trigger condition may occur, and may be detected or enabled to be detected. In any of the forgoing cases, the one or more processors can control at least one operation of the electromechanical device 102. The automated control can function as a safety feature for the patient as the control mitigates the patient's risk of further injury.

The electromechanical device 802 may be an adjustable pedaling device for exercising, strengthening, and rehabilitating arms and/or legs of a user. The electromechanical device 802 may include at least one or more motor controllers 804, one or more electric motors 806, and one or more radially-adjustable couplings 808. Two pedals 810 may be coupled to two radially-adjustable couplings 808 via left and right pedal assemblies that each include respective stepper motors. The motor controller 804 may be operatively coupled to the electric motor 806 and configured to provide commands to the electric motor 806 to control operation of the electric motor 806. The motor controller 804 may include any suitable microcontroller including a circuit board having one or more processing devices, one or more memory devices (e.g., read-only memory (ROM) and/or random access memory (RAM)), one or more network interface cards, and/or programmable input/output peripherals. The motor controller 804 may provide control signals or commands to drive the electric motor 806. The electric motor 806 may be powered to drive one or more radially-adjustable couplings 808 of the electromechanical device 802 in a rotational manner. The electric motor 806 may provide the driving force to rotate the radially-adjustable couplings 808 at configurable speeds. The couplings 808 are radially-adjustable in that a pedal 810 attached to the coupling 808 may be adjusted to a number of positions on the coupling 808 in a radial fashion. Further, the electromechanical device 802 may include current shunt to provide resistance to dissipate energy from the electric motor 806. As such, the electric motor 806 may be configured to provide resistance to rotation of the radially-adjustable couplings 808.

The computing device 102 may be communicatively connected to the electromechanical device 802 via the network interface card on the motor controller 804. The computing device 102 may transmit commands to the motor controller 804 to control the electric motor 806. The network interface card of the motor controller 804 may receive the commands and transmit the commands to the electric motor 806 to drive the electric motor 806. In this way, the computing device 102 is operatively coupled to the electric motor 806.

The computing device 102 and/or the motor controller 804 may be referred to as a control system herein. The patient portal 114 may be referred to as a user interface of the control system herein. The control system may control the electric motor 806 to operate in a number of modes: passive, active-assisted, resistive, and active. The passive mode may refer to the electric motor 806 independently driving the one or more radially-adjustable couplings 808 rotationally coupled to the one or more pedals 810. In the passive mode, the electric motor 806 may be the only source of driving force on the radially-adjustable couplings. That is, the user may engage the pedals 810 with their hands or their feet and the electric motor 806 may rotate the radially-adjustable couplings 808 for the user. This may enable moving the affected body part and stretching the affected body part without the user exerting excessive force.

The active-assisted mode may refer to the electric motor 806 receiving measurements of revolutions per minute of the one or more radially-adjustable couplings 808, and causing the electric motor 806 to drive the one or more radially-adjustable couplings 808 rotationally coupled to the one or more pedals 810 when the measured revolutions per minute satisfy a parameter (e.g., a threshold condition). The threshold condition may be configurable by the user and/or the physician. The electric motor 806 may be powered off while the user provides the driving force to the radially-adjustable couplings 808 as long as the revolutions per minute are above a revolutions per minute threshold and the threshold condition is not satisfied. When the revolutions per minute are less than the revolutions per minute threshold then the threshold condition is satisfied and the electric motor 806 may be controlled to drive the radially-adjustable couplings 808 to maintain the revolutions per minute threshold.

The resistive mode may refer to the electric motor 806 providing resistance to rotation of the one or more radially-adjustable couplings 808 coupled to the one or more pedals 810. The resistive mode may increase the strength of the body part being rehabilitated by causing the muscle to exert force to move the pedals against the resistance provided by the electric motor 806.

The active mode may refer to the electric motor 806 powering off to provide no driving force assistance to the radially-adjustable couplings 808. Instead, in this mode, the user provides the sole driving force of the radially-adjustable couplings using their hands or feet, for example.

During one or more of the modes, each of the pedals 810 may measure force exerted by a part of the body of the user on the pedal 810. For example, the pedals 810 may each contain any suitable sensor (e.g., strain gauge load cell, piezoelectric crystal, hydraulic load cell, etc.) for measuring force exerted on the pedal 810. Further, the pedals 810 may each contain any suitable sensor for detecting whether the body part of the user separates from contact with the pedals 810. In some embodiments, the measured force may be used to detect whether the body part has separated from the pedals 810. The force detected may be transmitted via the network interface card of the pedal 810 to the control system (e.g., computing device 102 and/or motor controller 804). As described further below, the control system may modify a parameter of operating the electric motor 806 based on the measured force. Further, the control system may perform one or more preventative actions (e.g., locking the electric motor 120 to stop the radially-adjustable couplings 808 from moving, slowing down the electric motor 806, presenting a notification to the user, etc.) when the body part is detected as separated from the pedals 810, among other things.

The goniometer 702 may be configured to measure angles of extension and/or bend of body parts and transmit the measured angles to the computing device 102 and/or the computing device 134. The goniometer 702 may be included in an electronic device that includes the one or more processing devices, memory devices, and/or network interface cards. The goniometer 702 may be disposed in a cavity of a mechanical brace. The cavity of the mechanical brace may be located near a center of the mechanical brace where the mechanical brace affords to bend and extend. The mechanical brace may be configured to secure to an upper body part (e.g., arm, etc.) and a lower body part (e.g., leg, etc.) to measure the angles of bend as the body parts are extended away from one another or retracted closer to one another.

The wristband 810 may include a 3-axis accelerometer to track motion in the X, Y, and Z directions, an altimeter for measuring altitude, and/or a gyroscope to measure orientation and rotation. The accelerometer, altimeter, and/or gyroscope may be operatively coupled to a processing device in the wristband 810 and may transmit data to the processing device. The processing device may cause a network interface card to transmit the data to the computing device 102 and the computing device 102 may use the data representing acceleration, frequency, duration, intensity, and patterns of movement to track steps taken by the user over certain time periods (e.g., days, weeks, etc.). The computing device 102 may transmit the steps to the master computing device 134 executing a clinical portal 134. Additionally, in some embodiments, the processing device of the wristband 810 may determine the steps taken and transmit the steps to the computing device 102. In some embodiments, the wristband 810 may use photoplethysmography (PPG) to measure heart rate that detects an amount of red light or green light on the skin of the wrist. For example, blood may absorb green light so when the heart beats, the blood flow may absorb more green light, thereby enabling detecting heart rate. The heart rate may be sent to the computing device 102 and/or the computing device 134.

The computing device 102 may present the steps taken by the user and/or the heart rate via respective graphical element on the patient portal 114, as discussed further below. The computing device may also use the steps taken and/or the heart rate to control a parameter of operating the electromechanical device 802. For example, if the heart rate exceeds a target heart rate for a pedaling session, the computing device 102 may control the electric motor 806 to reduce resistance being applied to rotation of the radially-adjustable couplings 808. In another example, if the steps taken are below a step threshold for a day, the treatment plan may increase the amount of time for one or more modes in which the user is to operate the electromechanical device 802 to ensure the affected body part is getting sufficient movement.

In some embodiments, the cloud-based computing system 142 may include one or more servers 144 that form a distributed computing architecture. Each of the servers 144 may include one or more processing devices, memory devices, data storage, and/or network interface cards. The servers 144 may be in communication with one another via any suitable communication protocol. The servers 144 may store profiles for each of the users that use the electromechanical device 802. The profiles may include information about the users such as a treatment plan, the affected body part, any procedure the user had performed on the affected body part, health, age, race, measured data from the goniometer 702, measured data from the wristband 810, measured data from the pedals 810, user input received at the patient portal 114 during operation of any of the modes of the treatment plan, a level of discomfort, comfort, or general patient satisfaction that the user experiences before and after any of the modes, before and after session images of the affected body part, and so forth.

In some embodiments the cloud-based computing system 142 may include a training engine 130 that is capable of generating one or more machine learning models 132. The one or more machine learning models 132 may be generated by the training engine 130 and may be implemented in computer instructions that are executable by one or more processing device of the training engine 130 and/or the servers 144. To generate the one or more machine learning models 132, the training engine 130 may train the one or more machine learning models 132. The training engine 130 may use a base data set of patient characteristics, treatment plans followed by the patient, and results of the treatment plan followed by the patients. The results may include information indicating whether the treatment plan led to full recovery of the affected body part, partial recovery of the affected body part, or lack of recovery of the affected body part. The one or more machine learning models 132 may refer to model artifacts that are created by the training engine 130 using training data that includes training inputs and corresponding target outputs. The training engine 130 may find patterns in the training data that map the training input to the target output, and generate the machine learning models 132 that capture these patterns. Although depicted separately from the computing device 102, in some embodiments, the training engine 130 and/or the machine learning models 132 may reside on the computing device 102 and/or the computing device 134.

As illustrated in FIGS. 8 and 11-12, the treatment device 106 may comprise an electromechanical device, such as a physical therapy device. FIG. 8 illustrates a perspective view of an example of a treatment device 800 according to certain aspects of this disclosure. Specifically, the treatment device 800 illustrated is an electromechanical device 802, such as an exercise and rehabilitation device (e.g., a physical therapy device or the like). The electromechanical device 802 is shown having pedal 810 on opposite sides that are adjustably positionable relative to one another on respective radially-adjustable couplings 808. The depicted electromechanical device 802 is configured as a small and portable unit so that it is easily transported to different locations at which rehabilitation or treatment is to be provided, such as at patients' homes, alternative care facilities, or the like. The patient may sit in a chair proximate the electromechanical device 802 to engage the electromechanical device 802 with the patient's feet, for example. The electromechanical device 802 includes a rotary device such as radially-adjustable couplings 808 or flywheel or the like rotatably mounted such as by a central hub to a frame or other support. The pedals 810 are configured for interacting with a patient to be rehabilitated and may be configured for use with lower body extremities such as the feet, legs, or upper body extremities, such as the hands, arms, and the like. For example, the pedal 810 may be a bicycle pedal of the type having a foot support rotatably mounted onto an axle with bearings. The axle may or may not have exposed end threads for engaging a mount on the radially-adjustable coupling 808 to locate the pedal on the radially-adjustable coupling 808. The radially-adjustable coupling 808 may include an actuator configured to radially adjust the location of the pedal to various positions on the radially-adjustable coupling 808.

Alternatively, the radially-adjustable coupling 808 may be configured to have both pedals 810 on opposite sides of a single coupling 808. In some embodiments, as depicted, a pair of radially-adjustable couplings 808 may be spaced apart from one another but interconnected to the electric motor 806. In the depicted example, the computing device 102 may be mounted on the frame of the electromechanical device 802 and may be detachable and held by the user while the user operates the electromechanical device 802. The computing device 102 may present the patient portal 114 and control the operation of the electric motor 806, as described herein.

In some embodiments, as described in U.S. Pat. No. 10,173,094 (U.S. application Ser. No. 15/700,293), which is incorporated by reference herein in its entirety for all purposes, the treatment device 106 may take the form of a traditional exercise/rehabilitation device which is more or less non-portable and remains in a fixed location, such as a rehabilitation clinic or medical practice. The treatment device 106 may include a seat and is less portable than the treatment device 106 shown in FIG. 8. FIG. 8 is not intended to be limiting: the treatment device 800 may include more or fewer components than those illustrated in FIG. 8.

FIGS. 11-12 generally illustrate an embodiment of a treatment device, such as a treatment device 10. More specifically, FIG. 11 generally illustrates a treatment device 10 in the form of an electromechanical device, such as a stationary cycling machine 14, which may be called a stationary bike, for short. The stationary cycling machine 14 includes a set of pedals 12 each attached to a pedal arm 20 for rotation about an axle 16. In some embodiments, and as generally illustrated in FIG. 11, the pedals 12 are movable on the pedal arm 20 in order to adjust a range of motion used by the patient in pedaling. For example, the pedals being located inwardly toward the axle 16 corresponds to a smaller range of motion than when the pedals are located outwardly away from the axle 16. A pressure sensor 18 is attached to or embedded within one of the pedals 12 for measuring an amount of force applied by the patient on the pedal 102. The pressure sensor 18 may communicate wirelessly to the treatment device 10 and/or to the patient interface 26. FIGS. 11-12 are not intended to be limiting: the treatment device 10 may include more or fewer components than those illustrated in FIGS. 11-12.

FIG. 13 generally illustrates a person (a patient) using the treatment device of FIG. 11, and showing sensors and various data parameters connected to a patient interface 26. The example patient interface 26 is a tablet computer or smartphone, or a phablet, such as an iPad, an iPhone, an Android device, or a Surface tablet, which is held manually by the patient. In some other embodiments, the patient interface 26 may be embedded within or attached to the treatment device 10. FIG. 13 generally illustrates the patient wearing the ambulation sensor 22 on his wrist, with a note showing “STEPS TODAY 1355”, indicating that the ambulation sensor 22 has recorded and transmitted that step count to the patient interface 26. FIG. 13 also generally illustrates the patient wearing the goniometer 24 on his right knee, with a note showing “KNEE ANGLE 72°”, indicating that the goniometer 24 is measuring and transmitting that knee angle to the patient interface 26. FIG. 13 generally illustrates a right side of one of the pedals 12 with a pressure sensor 18 showing “FORCE 12.5 lbs.”, indicating that the right pedal pressure sensor 18 is measuring and transmitting that force measurement to the patient interface 26. FIG. 13 also generally illustrates a left side of one of the pedals 12 with a pressure sensor 18 showing “FORCE 27 lbs.”, indicating that the left pedal pressure sensor 18 is measuring and transmitting that force measurement to the patient interface 26. FIG. 13 also generally illustrates other patient data, such as an indicator of “SESSION TIME 0:04:13”, indicating that the patient has been using the treatment device 10 for 4 minutes and 13 seconds. This session time may be determined by the patient interface 26 based on information received from the treatment device 10. FIG. 13 also generally illustrates an indicator showing “PAIN LEVEL 3”, Such a pain level may be obtained from the patient in response to a solicitation, such as a question, presented upon the patient interface 26.

FIG. 9 illustrates a computer-implemented method 900 for enabling a remote adjustment of a device. The device may be a treatment device, such as the treatment device 800, the device 10, or any other desired device. The device may comprise at least one of a physical therapy device (e.g., the rehabilitation device 802), a brace (e.g., the brace 202), a cap (e.g., the cap 204), a mat (e.g., the mat 206), a wrap (e.g., the wrap 208), a treatment device (e.g., the treatment device 10, the treatment device 106, the stationary cycling machine 14, or the like), any other suitable device, or combination thereof. The device may be configured to be manipulated by a user while the user performs a treatment plan. The method 900 may be performed at a processing device operatively coupled to the remote examination system 100, the system 800, or any combination thereof. For example, the method may be performed using a patient interface comprising an output device configured to present telemedicine information associated with a telemedicine session. The steps of the method 900 may be stored in a non-transient computer-readable storage medium.

A healthcare provider can use information obtained from an examination of a patient to determine a proper treatment plan for the patient. Using the systems 100, 800, the healthcare provider can conduct a remote physical examination of the one or more body parts of the patient and/or view results of an exercise, rehabilitation, or other session to provide a treatment plan for the patient. For example, the healthcare provider can conduct the remote physical examination during a telemedicine session.

At step 902, the method 900 includes receiving a treatment plan for a patient. The treatment plan can be received from a clinical portal 134. For example, the healthcare provider may input a treatment plan into the clinical portal 134, which in turn can transmit the treatment plan to the slave computing device 102 and the treatment device 106, 800. For example, the transmission of the treatment plan can be transmitted during a telemedicine session or at another desired time.

At step 904, the method 900 includes using the treatment plan to generate at least one parameter. The at least one parameter may be generated during a telemedicine session or at another desired time. The treatment plan may include a plan to treat a patient (e.g., prehabilitation, rehabilitation, or the like). The plan may include patient information (e.g., patient health history, characteristics of an injury, etc.), one or more types of exercises, a schedule of when and for how long to perform the exercises, at least one threshold that the patient should meet and/or not exceed, any other suitable information, or combination thereof. The processing device can use the information in the treatment plan to generate the at least one parameter. For example, the at least one parameter may be a measurable threshold or threshold ranges of data to be detected by the sensor(s) relating to the patient (e.g., pain level, vital signs, etc.) or to the operation of the treatment device 106, 800 (e.g., volume of sections 210, revolutions per minute, angle of the pedals 810, etc.). The at least one parameter can be at least one of a force parameter, a resistance parameter, a range of motion parameter, a temperature parameter, a pain level parameter, an exercise session parameter, a vital sign parameter, a time parameter, any other suitable parameter, or combination thereof. In one example, the force parameter may be based on characteristics of the injury, the patient, the treatment plan, the recovery results, the examination results, the pain level, any other suitable factors, or combination thereof. The force parameter may pertain to the pain level of the patient and include a measured level of force for the patient to exert on the pedals 810. The resistance parameter may be a parameter pertaining to a measured amount of resistance that the motor 806 applies to the pedals 810 during a cycling session. The range of motion parameter may be a parameter pertaining to a measured range of motion of a patient's body part (e.g., a knee). The temperature parameter may be a parameter pertaining to a measured temperature of the patient or the patient's body part. The pain level parameter may be a parameter pertaining to a level of pain that the patient reports or experiences before, during, or after the patient uses the treatment device 800. The exercise session parameter may be a parameter pertaining to a type of exercise, a number of steps that the patient has taken during the day and/or during an exercise session, or any other suitable exercise information. The exercise session can include a session for any purpose, including rehabilitation, prehabilitation, exercise, strength training, endurance training, any other type of exercise, or combination thereof. The vital sign parameter may be a parameter pertaining to a measurement of the patient's heart rate, pulse rate, blood pressure, respiration rate, or any other vital sign. The time parameter may be a parameter pertaining to an amount of time (e.g., minutes) for which the patient should engage in an exercise session, an amount of time (e.g., hours) between exercise sessions, any other suitable time measurements, or combination thereof.

At step 906, the method 900 includes receiving data correlating with at least one operation of the device. The data may be received during a telemedicine session or at another desired time. The device may comprise one or more sensors for detecting data correlating with the at least one operation. Examples of the measured properties may include, but are not limited to, angles of bend/extension, pressure exerted on the device, the speed of rotating the device (e.g., pedaling speed), the amount of resistance (e.g., pedal resistance), the distance the patient has traveled (e.g., cycled, walked, etc.), the number of steps the patient has taken, images of the examined/treated body part, and vital signs of the patient, such as heart rate and temperature. The data can be received from the one or more sensors in real-time or near real-time.

At step 908, the method 900 includes determining if a trigger condition has occurred. The trigger may be determined during a telemedicine session or at another desired time. A trigger condition is a condition that occurs when at least one of the data, the at least one parameter, a patient input, any other suitable information, or combination thereof is outside of the at least one parameter. Patient input may include a pain level, a pain tolerance, a weight, or any other suitable information from the patient. In one embodiment, the processing device may use the measured heart rate to determine if the heart rate is outside of the vital sign parameter (e.g., above and/or below a heart rate threshold). In another example, the processing device may use the counted number of steps taken to determine if the number of steps taken is outside of the exercise session parameter (e.g., above and/or below a step threshold). If one or more measurements are outside of the respective parameters (e.g., if the patient's heart rate is above the heart rate threshold, if the number of steps the patient has taken during the day is below the step threshold), a trigger condition has occurred. Patient input may be received during a telemedicine session or at another desired time.

At step 910, responsive to at least one trigger condition occurring, the method 900 proceeds with controlling at least one operation of the device. The processing device may control the operation of the device (e.g., the treatment device 106, 800). The processing device may control the operation of the device during a telemedicine session or at another desired time. The controlling of the at least one operation of the device can include causing the device to modify at least one of a volume, a pressure, a resistance, an angle, a speed, an angular or rotational velocity, and a time period. The modification may include not just a value but also a constraint, limitation, maximum, minimum, etc. For example, if the heart rate of the patient exceeds a vital sign parameter for a pedaling session, the computing device 102 may control the electric motor 806 to reduce the resistance being applied to the rotation of the radially-adjustable couplings 808. The motor controller 804 may be operatively coupled to the electric motor 806 and configured to provide commands to the electric motor 806 to control operation of the electric motor 806. In another example, if a volume of a section 210 of the treatment device 106 exceeds the volume parameter, the processing device may control the treatment device 106 to deflate the section 210 to a volume within the volume parameter. In this example, if the measured level of volume exceeds the volume parameter, the excess pressure that the treatment device 106 may be exerting on the patient may cause the patient pain or discomfort, and thus, the processing device is configured to adjust the volume (e.g., decrease the volume) to decrease the pressure exerted on the patient.

At step 912, the method 900 proceeds with transmitting a notification to a clinical portal. The notification may be transmitted during a telemedicine session or at another desired time. The notification may include results of an exercise session, the patient's recovery results, the vital sign(s), the pain level, input from the patient, any other suitable information, or combination thereof. The notification can be transmitted to the clinical portal 134 in real-time, in near real-time, before or after an exercise session, at any other suitable time, or combination thereof. The notification can assist the healthcare provider in assessing the patient's treatment plan and making any adjustments to the treatment plan that may optimize the patient's treatment (i.e., to decrease the patient's recovery time; to increase the patient's strength, range of motion, and flexibility, etc.).

At step 914, the method 900 proceeds with receiving at least one adjusted parameter. The parameter may be received during a telemedicine session or at another desired time. The healthcare provider may input the at least one adjusted parameter to the clinical portal 134 for transmitting to the patient portal 114, the treatment device 106, 800, the slave computing device 102, or any combination thereof. For example, while using the rehabilitation device 802 over the course of a few days, if the patient is not within the time parameter (e.g., not exercising for a long enough period of time) and if the patient's pain level exceeds a pain level parameter, the healthcare provider may adjust the time parameter (e.g., to decrease the amount of time for the exercise) and adjust the force parameter (e.g., to increase the level of motor assistance for a cycling exercise). Such adjustments may result in improved patient compliance with the treatment plan and decrease the patient's recovery time. The at least one adjusted parameter can be received in real-time, in near real-time, prior to an exercise session, at any other suitable time, or any combination thereof. For example, the healthcare provider may be remotely reviewing the notification(s) in real-time or near real-time while a patient is engaging in an exercise session and/or after the patient has finished the exercise session. As an example, the healthcare provider may upload the treatment plan, the adjusted treatment plan, and/or the adjusted parameter one day and the patient may use the device at a later time, such as later in the day, the following morning, the following day, or the following week, etc.

In another embodiment, the method 900 receives an adjusted treatment plan, such as from the clinical portal 134. The adjusted treatment plan may be received during a telemedicine session or at another desired time. The adjusted treatment plan may include at least some different information from the treatment plan. For example, the doctor may have used the notification, client input, results from the exercise session, any other suitable information, or combination thereof to make a change to the treatment plan. The processing device may use the adjusted treatment plan to generate an adjusted parameter.

At step 916, the method 900 proceeds with using the at least one adjusted parameter to control the at least one operation of the device. The at least one adjusted parameter may be used to control the at least one operation of the device during a telemedicine session or at another desired time. In one example, if the steps taken by a patient are below an exercise session parameter (e.g., a step threshold for a day), the exercise session parameter may be adjusted to increase the amount of time for one or more modes in which the patient is to operate the electromechanical device 802 to ensure the affected body part is getting sufficient movement. The at least one adjusted parameter can be used in real-time or near real-time to control the at least one operation of the device. For example, if the healthcare provider is remotely observing the patient during the exercise session (e.g., reviewing the results of the exercise session, notifications, etc.) and provides an adjusted parameter while the patient is using the device, the at least one operation of the electromechanical device 802 can be adjusted in real-time or near real-time (e.g., providing motor assist while the patient is cycling). The at least one adjusted parameter can be received prior to the patient operating the device to control the at least one operation of the device at a time subsequent to receiving the at least one adjusted parameter. For example, the healthcare provider may determine that the patient is recovering and adjust one or more parameters (e.g., increase motor resistance on the pedals 810) to increase the intensity of the workout so that the patient can rebuild muscle strength and recover more quickly.

FIG. 9 is not intended to be limiting: the method 900 can include more or fewer steps and/or processes than those illustrated in FIG. 9. Further, the order of the steps of the method 900 is not intended to be limiting; the steps can be arranged in any suitable order.

FIG. 10 illustrates, in accordance with one or more aspects of the present disclosure, an example computer system 1000 which can perform any one or more of the methods described herein. The computer system 1000 may correspond to the slave computing device 102 (e.g., a patient's computing device), the master computing device 122 (e.g., a healthcare provider's computing device), one or more servers of the cloud-based computing system 142, the training engine 146, the server 144, the slave pressure system 110, the master pressure system 130, the slave controller 118, the master controller 138, the imaging device 116, the master display 136, the treatment device 106, the master device 126, the master console 124, the treatment device 800, the motor controller 804, the electric motor 806, the radially-adjustable couplings 808, the pedals 810, the goniometer 702, and/or the wristband 704 illustrated in FIGS. 1 and/or 7. The computer system 1000 may be capable of executing the patient portal 114 and/or clinical portal 134 of FIGS. 1 and 7. The computer system 1000 may be connected (e.g., networked) to other computer systems in a LAN, an intranet, an extranet, or the Internet. The computer system 1000 may operate in the capacity of a server in a client-server network environment. The computer system may be a personal computer (PC), a tablet computer, a motor controller, a goniometer (e.g., the goniometer 702), a wearable (e.g., the wristband 704), a set-top box (STB), a personal Digital Assistant (PDA), a mobile phone, a camera, a video camera, or any device capable of executing a set of instructions (sequential or otherwise) that specify actions to be taken by that device. Further, while only a single computer system is illustrated, the term “computer” shall also be taken to include any collection of computers that individually or jointly execute a set (or multiple sets) of instructions to perform any one or more of the methods discussed herein.

The computer system 1000 includes a processing device 1002 (e.g., the slave processing device, the master processing device), a main memory 1004 (e.g., read-only memory (ROM), flash memory, dynamic random access memory (DRAM) such as synchronous DRAM (SDRAM)), a static memory 1006 (e.g., flash memory, static random access memory (SRAM)), and a data storage device 1008, which communicate with each other via a bus 1010.

The processing device 1002 represents one or more general-purpose processing devices such as a microprocessor, central processing unit, or the like. More particularly, the processing device 1002 may be a complex instruction set computing (CISC) microprocessor, reduced instruction set computing (RISC) microprocessor, very long instruction word (VLIW) microprocessor, or a processor implementing other instruction sets or processors implementing a combination of instruction sets. The processing device 1002 may also be one or more special-purpose processing devices such as an application specific integrated circuit (ASIC), a field programmable gate array (FPGA), a digital signal processor (DSP), network processor, or the like. The processing device 1002 is configured to execute instructions for performing any of the operations and steps discussed herein.

The computer system 1000 may further include a network interface device 1012. The computer system 1000 also may include a video display 1014 (e.g., a liquid crystal display (LCD), a light-emitting diode (LED), an organic light-emitting diode (OLED or Organic LED), or a cathode ray tube (CRT)). The video display 1014 can represent the master display 136 or any other suitable display. The computer system 1000 may include one or more input devices 1016 (e.g., a keyboard, a mouse, the goniometer 702, the wristband 704, the imaging device 116, or any other suitable input). The computer system 1000 may include one or more output devices (e.g., a speaker 1018). In one illustrative example, the video display 1014, the input device(s) 1016, and/or the speaker 1018 may be combined into a single component or device (e.g., an LCD touch screen).

The data storage device 1008 may include a computer-readable medium 1020 on which the instructions 1022 (e.g., implementing the control system, the patient portal 114, the clinical portal 134, and/or any functions performed by any device and/or component depicted in the FIGS. and described herein) embodying any one or more of the methodologies or functions described herein are stored. The instructions 1022 may also reside, completely or at least partially, within the main memory 1004 and/or within the processing device 1002 during execution thereof by the computer system 1000. As such, the main memory 1004 and the processing device 1002 also constitute computer-readable media. The instructions 1022 may further be transmitted or received over a network via the network interface device 1012.

While the computer-readable storage medium 1020 is shown in the illustrative examples to be a single medium, the term “computer-readable storage medium” should be taken to include a single medium or multiple media (e.g., a centralized or distributed database, and/or associated caches and servers) that store the one or more sets of instructions. The term “computer-readable storage medium” shall also be taken to include any medium capable of storing, encoding or carrying a set of instructions for execution by the machine and that cause the machine to perform any one or more of the methodologies of the present disclosure. The term “computer-readable storage medium” shall accordingly be taken to include, but not be limited to, solid-state memories, optical media, and magnetic media.

In one exemplary embodiment, the computer system 1000 includes the input device 1016 (e.g., the master console 124 comprising the master device 126) and the control system comprising the processing devices 1002 (e.g., the master processing device) operatively coupled to the input device 1016 and the treatment device 106. The system 1000 may comprise one or more memory devices (e.g., main memory 1004, data storage device 1008, etc.) operatively coupled to the processing device 1002. The one or more memory devices can be configured to store instructions 1022. The processing device 1002 can be configured to execute the instructions 1022 to receive the slave sensor data from the one or more slave sensors 108, to use a manipulation of the master device 126 to generate a manipulation instruction, to transmit the manipulation instruction, and to use the manipulation instruction to cause the slave pressure system 110 to activate. The instructions can be executed in real-time or near real-time.

The processing device 1002 can be further configured to use the slave sensor data to transmit an augmented image 400 to the video display (e.g., the master display 136). The healthcare provider may view the augmented image 400 and/or virtually touch the augmented image using the video display 1014. In other words, the augmented image 400 may comprise a representation of the treatment device 106 and one or more body parts of the patient. The representation may be displayed in 2D, 3D, or any other suitable dimension. As the healthcare provider conducts the remote examination during a telemedicine session, the augmented image 400 may change to reflect the manipulations of the treatment device 106 and/or of any movement of the patient's one or more body parts.

The augmented image 400 can comprise one or more pressure indicators, temperature indicators, any other suitable indicator, or combination thereof. Each pressure indicator can represent a measured level of force (i.e., based on the slave force measurements). Each temperature indicator can represent a measured level of temperature (i.e., based on the slave temperature measurements). For example, the pressure indicators and/or the temperature indicators may be different colors, each color associated with one of the measured levels of force and temperature, respectively. The indicators may be displayed as a map. The map may be a gradient map displaying the pressure indicators and/or temperature indicators. The map may be overlaid over the augmented image. The map may be transmitted to the clinical portal, the master display, the patient portal, any other suitable display, or combination thereof.

The processing device 1002 can be further configured to use the slave sensor data (e.g., the slave force measurements) to provide a corresponding level of measured force to the master device 126. In other words, while using the master device 126, the healthcare provider can essentially feel the measured levels of force exerted by the patient's one or more body parts during the remote examination.

As the healthcare provider is virtually examining the patient, the processing device 1002 can use the master sensor data to generate and transmit the manipulation instruction (e.g., a measured level of force) to manipulate the treatment device 106. In other words, as the healthcare provider applies more force pressure) to the master device 126, the master sensors 128 can detect the measured level of force and instruct the treatment device 106 to apply a correlated measured level of force. In some embodiments, the measured level of force can be based on a proximity of the master device 126 to the representation. In other words, as the healthcare provider manipulates the master device 126 closer to the representation and/or within the representation of the treatment device 126 and/or the patient's one or more body parts, the master sensors 128 can detect that the measured force has increased. In some embodiments, the input device 1016 can comprise a pressure gradient. Using the pressure gradient, the processing device 1002 can be configured to cause the slave pressure system 110 to apply one or more measured levels of force to one or more sections 210 of the treatment device 106.

In another exemplary embodiment, the computer system 1000 may include the input device 1016 (e.g., the treatment device 106) and the control system comprising the processing device 1002 (e.g., the slave processing device) operatively coupled to the input device 1016 and the master device 126. The system 1000 may comprise one or more memory devices (e.g., main memory 1004, data storage device 1008, etc.) operatively coupled to the processing device 1002. The one or more memory devices can be configured to store instructions 1022. The processing device 1002 can be configured to execute the instructions 1022 to receive the slave sensor data from the one or more slave sensors 108, to transmit the slave sensor data, to receive the manipulation instruction, and to use the manipulation instruction to activate the slave pressure system 110. The instructions can be executed in real-time or near real-time.

In yet another embodiment, the computer system 1000 may include one or more input devices 1016 (e.g., the master console 124 comprising the master device 126, the treatment device 106, etc.) and the control system comprising one or more processing devices 1002 (e.g., the master processing device, the slave processing device) operatively coupled to the input devices 1016. For example, the master processing device may be operatively coupled to the master console 124 and the slave processing device may be operatively coupled to the treatment device 106. The system 1000 may comprise one or more memory devices (e.g., master memory coupled to the master processing device, slave memory coupled to the slave processing device, etc.) operatively coupled to the one or more processing devices 1002. The one or more memory devices can be configured to store instructions 1022 (e.g., master instructions, slave instructions, etc.). The one or more processing devices 1002 (e.g., the master processing device) can be configured to execute the master instructions 1022 to receive the slave sensor data from the slave processing device, use a manipulation of the master device 126 to generate a manipulation instruction, and transmit the manipulation instruction to the slave processing device. The one or more processing devices 1002 (e.g., the slave processing device) can be configured to execute the slave instructions 1022 to receive the slave sensor data from the one or more slave sensors, to transmit the slave sensor data to the master processing device, to receive the manipulation instruction from the master processing device, and to use the manipulation instruction to activate the slave pressure system. The instructions can be executed in real-time or near real-time.

In another exemplary embodiment, the computer system 1000 may include the input device 1016 (e.g., the treatment device 800) and the control system comprising the processing device 1002 (e.g., the slave processing device) operatively coupled to the input device 1016 and the master computing device 122. The system 1000 may comprise one or more memory devices (e.g., main memory 1004, data storage device 1008, etc.) operatively coupled to the processing device 1002. The one or more memory devices can be configured to store instructions 1022. The processing device 1002 can be configured to execute the instructions 1022 to receive a treatment plan (e.g., from a clinical portal 134) for a patient and to use the treatment plan to generate at least one parameter. The at least one parameter can be at least one of a force parameter, a resistance parameter, a range of motion parameter, a temperature parameter, a pain level parameter, an exercise session parameter, a vital sign parameter, and a time parameter. Responsive to the at least one trigger condition occurring, the instructions can further cause the processing device 1002 to control at least one operation of the treatment device 800. The controlling of the at least one operation of the device can comprise causing the treatment device 800 to modify at least one of a volume, a pressure, a resistance, an angle, a speed, an angular or rotational velocity, and a time period. The processing device 1002 can be further configured to execute the instructions 1022 to receive the slave sensor data (e.g., data associated with the at least one operation) from the one or more slave sensors 108. To determine the at least one trigger condition, the instructions 1022 can further cause the processing device 1002 to use at least one of the data, the at least one parameter, and a patient input. The instructions 1022 can be executed in real-time or near real-time. For example, a notification can be transmitted to the clinical portal 134 in real-time or near real-time, the at least one adjusted parameter can be received in real-time or near real-time, and, using the at least one adjusted parameter, the at least one operation of the treatment device 800 can be controlled in real-time or near real-time. The instructions 1022 can be executed at any other suitable time. For example, the notification can be transmitted to a clinical portal 134 at a first time, the at least one adjusted parameter can be received by the treatment device 800 at a second time, and, using the at least one adjusted parameter, the at least one operation of the treatment device 800 can be controlled at a third time subsequent to the first and second times (i.e., subsequent to transmitting the notification and receiving the at least one adjusted parameter).

FIG. 10 is not intended to be limiting: the system 1000 may include more or fewer components than those illustrated in FIG. 10.

Any of the systems and methods described in this disclosure may be used in connection with rehabilitation. Unless expressly stated otherwise, is to be understood that rehabilitation includes prehabilitation (also referred to as “pre-habilitation” or “prehab”). Prehabilitation may be used as a preventative procedure or as a pre-surgical or pre-treatment procedure. Prehabilitation may include any action performed by or on a patient (or directed to be performed by or on a patient, including, without limitation, remotely or distally through telemedicine) to, without limitation, prevent or reduce a likelihood of injury (e.g., prior to the occurrence of the injury); improve recovery time subsequent to surgery; improve strength subsequent to surgery; or any of the foregoing with respect to any non-surgical clinical treatment plan to be undertaken for the purpose of ameliorating or mitigating injury, dysfunction, or other negative consequence of surgical or non-surgical treatment on any external or internal part of a patient's body. For example, a mastectomy may require prehabilitation to strengthen muscles or muscle groups affected directly or indirectly by the mastectomy. As a further non-limiting example, the removal of an intestinal tumor, the repair of a hernia, open-heart surgery or other procedures performed on internal organs or structures, whether to repair those organs or structures, to excise them or parts of them, to treat them, etc., can require cutting through and harming numerous muscles and muscle groups in or about, without limitation, the abdomen, the ribs and/or the thoracic cavity. Prehabilitation can improve a patient's speed of recovery, measure of quality of life, level of pain, etc. in all the foregoing procedures. In one embodiment of prehabilitation, a pre-surgical procedure or a pre-non-surgical-treatment may include one or more sets of exercises for a patient to perform prior to such procedure or treatment. The patient may prepare an area of his or her body for the surgical procedure by performing the one or more sets of exercises, thereby strengthening muscle groups, improving existing and/or establishing new muscle memory, enhancing mobility, improving blood flow, and/or the like.

In some embodiments, the systems and methods described herein may use artificial intelligence and/or machine learning to generate a prehabilitation treatment plan for a user. Additionally, or alternatively, the systems and methods described herein may use artificial intelligence and/or machine learning to recommend an optimal exercise machine configuration for a user. For example, a data model may be trained on historical data such that the data model may be provided with input data relating to the user and may generate output data indicative of a recommended exercise machine configuration for a specific user. Additionally, or alternatively, the systems and methods described herein may use machine learning and/or artificial intelligence to generate other types of recommendations relating to prehabilitation, such as recommended reading material to educate the patient, a recommended health professional specialist to contact, and/or the like.

Consistent with the above disclosure, the examples of systems and methods enumerated in the following clauses are specifically contemplated and are intended as a non-limiting set of examples.

Clause 1. A computer-implemented system, comprising:

a treatment device configured to be manipulated by a user while the user performs a treatment plan;

a patient interface comprising an output device configured to present telemedicine information associated with a telemedicine session; and

a processing device configured to:

receive a treatment plan for a patient;

during the telemedicine session, use the treatment plan to generate at least one parameter; and

responsive to at least one trigger condition occurring, control at least one operation of the treatment device.

Clause 2. The computer-implemented system of any clause herein, wherein the treatment device comprises a sensor for detecting data associated with the at least one operation.

Clause 3. The computer-implemented system of any clause herein, wherein the processing device is configured to receive the data from the sensor in real-time or near real-time.

Clause 4. The computer-implemented system of any clause herein, wherein, to determine the at least one trigger condition, the one or more processing devices are configured to use at least one of the data, the at least one parameter, and a patient input.

Clause 5. The computer-implemented system of any clause herein, wherein the controlling of the at least one operation of the device comprises causing the device to modify at least one of a volume, a pressure, a resistance, an angle, a speed, an angular or rotational velocity, and a time period.

Clause 6. The computer-implemented system of any clause herein, wherein the at least one parameter is at least one of a force parameter, a resistance parameter, a range of motion parameter, a temperature parameter, a pain level parameter, an exercise session parameter, a vital sign parameter, and a time parameter.

Clause 7. A system for a remote examination of a patient, comprising:

a master console comprising a master device;

a treatment device comprising one or more slave sensors and a slave pressure system; and

a control system comprising one or more processing devices operatively coupled to the master console and the treatment device, wherein the one or more processing devices are configured to:

receive slave sensor data from the one or more slave sensors;

use a manipulation of the master device to generate a manipulation instruction;

transmit the manipulation instruction; and

use the manipulation instruction to cause the slave pressure system to activate.

Clause 8. The system of any clause herein, wherein the master device comprises master sensors for detecting master sensor data associated with the manipulation; and

wherein the manipulation instruction is based on the master sensor data.

Clause 9. The system of any clause herein, wherein the slave sensor data comprises slave force measurements;

wherein the master device comprises a master pressure system; and

wherein, using the slave force measurements, the one or more processing devices are further configured to activate the master pressure system.

Clause 10. The system of any clause herein, further comprising:

a second master device comprising a second master pressure system; wherein the slave sensor data comprises slave force measurements; and

wherein, using the slave force measurements, the one or more processing devices are further configured to activate the second master pressure system.

Clause 11. The system of any clause herein, wherein the one or more processing devices are further configured to:

use the slave sensor data to transmit an augmented image to a master display.

Clause 12. The system of any clause herein, wherein the slave sensor data comprises slave force measurements;

wherein the augmented image comprises one or more pressure indicators; and

wherein the one or more pressure indicators are based on the slave force measurements.

Clause 13. The system of any clause herein, wherein the slave sensor data comprises slave temperature measurements;

wherein the augmented image comprises one or more temperature indicators; and

wherein the one or more temperature indicators are based on the slave temperature measurements.

Clause 14. The system of any clause herein, wherein the master device comprises a pressure gradient; and

wherein, using the pressure gradient, the one or more processing devices are configured to cause the slave pressure system to apply one or more measured levels of force to one or more sections of the treatment device.

Clause 15. The system of any clause herein, wherein the augmented image comprises a representation of at least one of the treatment device and a body part of the patient, and wherein the representation is in 2D or 3D.

Clause 16. The system of any clause herein, wherein the manipulation instruction comprises a measured level of force; and

wherein the measured level of force is based on a proximity of the master device to the representation.

Clause 17. The system of any clause herein, wherein the one or more processing devices are further configured to:

transmit the manipulation instruction in real-time or near real-time; and

cause the slave pressure system to activate in real-time or near real-time.

Clause 18. The system of any clause herein, wherein the master device comprises at least one of a glove device, a joystick, and a model of the treatment device.

Clause 19. The system of any clause herein, wherein the treatment device comprises at least one of a brace, a cap, a mat, and a wrap.

Clause 20. The system of any clause herein, further comprising one or more memory devices operatively coupled to the one or more processing devices, wherein the one or more memory devices stores instructions, and wherein the one or more processing devices are configured to execute the instructions.

Clause 21. A method for operating a system for remote examination of a patient, comprising:

receiving slave sensor data from one or more slave sensors;

based on a manipulation of a master device, generating a manipulation instruction;

transmitting the manipulation instruction; and

based on the manipulation instruction, causing a slave pressure system to activate.

Clause 22. The method of any clause herein, wherein the master device comprises master sensors for detecting master sensor data associated with the manipulation; and

wherein the manipulation instruction is based on the master sensor data.

Clause 23. The method of any clause herein, wherein the slave sensor data comprises slave force measurements;

wherein the master device comprises a master pressure system; and

wherein, based on the slave force measurements, activating the master pressure system.

Clause 24. The method of any clause herein, further comprising:

a second master device comprising a second master pressure system; wherein the slave sensor data comprises slave force measurements; and

wherein, using the slave force measurements, the one or more processing devices are further configured to activate the second master pressure system.

Clause 25. The method of any clause herein, further comprising:

use the slave sensor data to transmitting an augmented image.

Clause 26. The method of any clause herein, wherein the slave sensor data comprises slave force measurements;

wherein the augmented image comprises one or more pressure indicators; and

wherein the one or more pressure indicators are based on the slave force measurements.

Clause 27. The method of any clause herein, wherein the slave sensor data comprises slave temperature measurements;

wherein the augmented image comprises one or more temperature indicators; and

wherein the one or more temperature indicators are based on the slave temperature measurements.

Clause 28. The method of any clause herein, wherein the master device comprises a pressure gradient; and

wherein, using the pressure gradient, causing the slave pressure system to apply one or more measured levels of force to one or more sections of the treatment device.

Clause 29. The method of any clause herein, wherein the augmented image comprises a representation of at least one of the treatment device and a body part of the patient, and wherein the representation is in 2D or 3D.

Clause 30. The method of any clause herein, wherein the manipulation instruction comprises a measured level of force; and

wherein the measured level of force is based on a proximity of the master device to the representation.

Clause 31. The method of any clause herein, further comprising:

transmitting the manipulation instruction in real-time or near real-time; and

causing the slave pressure system to activate in real-time or near real-time.

Clause 32. The method of any clause herein, wherein the master device comprises at least one of a glove device, a joystick, and a model of the treatment device.

Clause 33. The method of any clause herein, wherein the treatment device comprises at least one of a brace, a cap, a mat, and a wrap.

Clause 34. A tangible, non-transitory computer-readable storage medium storing instructions that, when executed, cause a processing device to:

receive slave sensor data from one or more slave sensors;

based on a manipulation of a master device, generate a manipulation instruction;

transmit the manipulation instruction; and

use the manipulation instruction to cause a slave pressure system to activate.

Clause 35. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the master device comprises master sensors for detecting master sensor data associated with the manipulation; and

wherein the manipulation instruction is based on the master sensor data.

Clause 36. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the slave sensor data comprises slave force measurements;

wherein the master device comprises a master pressure system; and

wherein, based on the slave force measurements, activate the master pressure system.

Clause 37. The tangible, non-transitory computer-readable storage medium of any clause herein, further comprising:

a second master device comprising a second master pressure system; wherein the slave sensor data comprises slave force measurements; and

wherein, using the slave force measurements, the one or more processing devices are further configured to activate the second master pressure system.

Clause 38. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the instructions further cause the processing device to:

use the slave sensor data to transmit an augmented image.

Clause 39. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the slave sensor data comprises slave force measurements;

wherein the augmented image comprises one or more pressure indicators; and

wherein the one or more pressure indicators are based on the slave force measurements.

Clause 40. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the slave sensor data comprises slave temperature measurements;

wherein the augmented image comprises one or more temperature indicators; and

wherein the one or more temperature indicators are based on the slave temperature measurements.

Clause 41. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the master device comprises a pressure gradient; and

wherein, using the pressure gradient, cause the slave pressure system to apply one or more measured levels of force to one or more sections of the treatment device.

Clause 42. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the augmented image comprises a representation of at least one of the treatment device and a body part of the patient, and wherein the representation is in 2D or 3D.

Clause 43. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the manipulation instruction comprises a measured level of force; and

wherein the measured level of force is based on a proximity of the master device to the representation.

Clause 44. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the instructions further cause the processing device to:

transmit the manipulation instruction in real-time or near real-time; and

cause the slave pressure system to activate in real-time or near real-time.

Clause 45. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the master device comprises at least one of a glove device, a joystick, and a model of the treatment device.

Clause 46. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the treatment device comprises at least one of a brace, a cap, a mat, and a wrap.

Clause 47. A system for a remote examination of a patient, comprising:

a master console comprising a master device;

a treatment device comprising one or more slave sensors and a slave pressure system; and

a control system comprising one or more processing devices operatively coupled to the master console and the treatment device, wherein the one or more processing devices are configured to:

receive slave sensor data from the one or more slave sensors;

transmit the slave sensor data;

receive a manipulation instruction; and

use the manipulation instruction to activate the slave pressure system.

Clause 48. The system of any clause herein, wherein the manipulation instruction is based on a manipulation of the master device.

Clause 49. The system of any clause herein, wherein the master device comprises master sensors for detecting master sensor data associated with the manipulation; and

wherein the manipulation instruction is based on the master sensor data.

Clause 50. The system of any clause herein, further comprising:

a second master device comprising a second master pressure system; wherein the slave sensor data comprises slave force measurements; and

wherein, using the slave force measurements, the one or more processing devices are further configured to activate the second master pressure system.

Clause 51. The system of any clause herein, wherein the one or more processing devices are further configured to:

use the slave sensor data to transmit an augmented image to the master console.

Clause 52. The system of any clause herein, wherein the slave sensor data comprises slave force measurements;

wherein the master device comprises a master pressure system; and

wherein, using the slave force measurements, the one or more processing devices are further configured to cause the master pressure system to activate.

Clause 53. The system of any clause herein, wherein the slave sensor data comprises slave force measurements;

wherein the augmented image comprises one or more pressure indicators; and

wherein the one or more pressure indicators are based on the slave force measurements.

Clause 54. The system of any clause herein, wherein the slave sensor data comprises slave temperature measurements;

wherein the augmented image comprises one or more temperature indicators; and

wherein the one or more temperature indicators are based on the slave temperature measurements.

Clause 55. The system of any clause herein, wherein the master device comprises a pressure gradient; and

wherein, using the pressure gradient, activating the slave pressure system comprises applying one or more measured levels of force to one or more sections of the treatment device.

Clause 56. The system of any clause herein, wherein the augmented image comprises a representation of at least one of the treatment device and a body part of the patient, and wherein the representation is in 2D or 3D.

Clause 57. The system of any clause herein, wherein the manipulation instruction comprises a measured level of force; and

wherein the measured level of force is based on a proximity of the master device to the representation.

Clause 58. The system of any clause herein, wherein the one or more processing devices are further configured to:

receive the manipulation instruction in real-time or near real-time; and

activate the slave pressure system in real-time or near real-time.

Clause 59. The system of any clause herein, wherein the master device comprises at least one of a glove device, a joystick, and a model of the treatment device.

Clause 60. The system of any clause herein, wherein the treatment device comprises at least one of a brace, a cap, a mat, and a wrap.

Clause 61. The system of any clause herein, further comprising one or more memory devices operatively coupled to the one or more processing devices, wherein the one or more memory devices stores instructions, and wherein the one or more processing devices are configured to execute the instructions.

Clause 62. A method for operating a system for remote examination of a patient, comprising:

receiving slave sensor data from one or more slave sensors;

transmitting the slave sensor data;

receiving a manipulation instruction; and

based on the manipulation instruction, activating a slave pressure system.

Clause 63. The method of any clause herein, wherein the manipulation instruction is based on a manipulation of a master device.

Clause 64. The method of any clause herein, wherein the master device comprises master sensors for detecting master sensor data associated with the manipulation; and wherein the manipulation instruction is based on the master sensor data.

Clause 65. The method of any clause herein, further comprising:

a second master device comprising a second master pressure system; wherein the slave sensor data comprises slave force measurements; and

wherein, using the slave force measurements, the one or more processing devices are further configured to activate the second master pressure system.

Clause 66. The method of any clause herein, further comprising:

use the slave sensor data to transmitting an augmented image to the master console.

Clause 67. The method of any clause herein, wherein the slave sensor data comprises slave force measurements;

wherein the master device comprises a master pressure system; and

wherein, based on the slave force measurements, causing the master pressure system to activate.

Clause 68. The method of any clause herein, wherein the slave sensor data comprises slave force measurements;

wherein the augmented image comprises one or more pressure indicators; and

wherein the one or more pressure indicators are based on the slave force measurements.

Clause 69. The method of any clause herein, wherein the slave sensor data comprises slave temperature measurements;

wherein the augmented image comprises one or more temperature indicators; and

wherein the one or more temperature indicators are based on the slave temperature measurements.

Clause 70. The method of any clause herein, wherein the master device comprises a pressure gradient; and

wherein, using the pressure gradient, activating the slave pressure system comprises applying one or more measured levels of force to one or more sections of the treatment device.

Clause 71. The method of any clause herein, wherein the augmented image comprises a representation of at least one of the treatment device and a body part of the patient, and wherein the representation is in 2D or 3D.

Clause 72. The method of any clause herein, wherein the manipulation instruction comprises a measured level of force; and

wherein the measured level of force is based on a proximity of the master device to the representation.

Clause 73. The method of any clause herein, further comprising:

receiving the manipulation instruction in real-time or near real-time; and

activating the slave pressure system in real-time or near real-time.

Clause 74. The method of any clause herein, wherein the master device comprises at least one of a glove device, a joystick, and a model of the treatment device.

Clause 75. The method of any clause herein, wherein the treatment device comprises at least one of a brace, a cap, a mat, and a wrap.

Clause 76. A tangible, non-transitory computer-readable storage medium storing instructions that, when executed, cause a processing device to:

receive slave sensor data from one or more slave sensors;

transmit the slave sensor data;

receive a manipulation instruction; and

use the manipulation instruction to activate a slave pressure system.

Clause 77. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the manipulation instruction is based on a manipulation of a master device.

Clause 78. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the master device comprises master sensors for detecting master sensor data associated with the manipulation; and

wherein the manipulation instruction is based on the master sensor data.

Clause 79. The tangible, non-transitory computer-readable storage medium of any clause herein, further comprising:

a second master device comprising a second master pressure system; wherein the slave sensor data comprises slave force measurements; and

wherein, using the slave force measurements, the one or more processing devices are further configured to activate the second master pressure system.

Clause 80. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the instructions further cause the processing device to:

use the slave sensor data to transmit an augmented image to the master console.

Clause 81. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the slave sensor data comprises slave force measurements;

wherein the master device comprises a master pressure system; and

wherein, based on the slave force measurements, cause the master pressure system to activate.

Clause 82. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the slave sensor data comprises slave force measurements;

wherein the augmented image comprises one or more pressure indicators; and

wherein the one or more pressure indicators are based on the slave force measurements.

Clause 83. The method of any clause herein, wherein the slave sensor data comprises slave temperature measurements;

wherein the augmented image comprises one or more temperature indicators; and

wherein the one or more temperature indicators are based on the slave temperature measurements.

Clause 84. The method of any clause herein, wherein the master device comprises a pressure gradient; and

wherein, using the pressure gradient, activating the slave pressure system comprises applying one or more measured levels of force to one or more sections of the treatment device.

Clause 85. The method of any clause herein, wherein the augmented image comprises a representation of at least one of the treatment device and a body part of the patient, and wherein the representation is in 2D or 3D.

Clause 86. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the manipulation instruction comprises a measured level of force; and

wherein the measured level of force is based on a proximity of the master device to the representation.

Clause 87. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the instructions further cause the processing device to:

receive the manipulation instruction in real-time or near real-time; and

activate the slave pressure system in real-time or near real-time.

Clause 88. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the master device comprises at least one of a glove device, a joystick, and a model of the treatment device.

Clause 89. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the treatment device comprises at least one of a brace, a cap, a mat, and a wrap.

Clause 90. A system for a remote examination of a patient, comprising:

a master console comprising a master device;

a treatment device comprising one or more slave sensors and a slave pressure system; and

a control system comprising a master processing device and a slave processing device, wherein the master processing device is operatively coupled to the master console and the slave processing device is operatively coupled to the treatment device;

wherein the master processing device is configured to:

receive slave sensor data from the slave processing device;

use a manipulation of the master device to generate a manipulation instruction; and

transmit the manipulation instruction to the slave processing device; and

wherein the slave processing device is configured to:

receive the slave sensor data from the one or more slave sensors;

transmit the slave sensor data to the master processing device;

receive the manipulation instruction from the master processing device; and

use the manipulation instruction to activate the slave pressure system.

Clause 91. The system of any clause herein, wherein the master device comprises master sensors for detecting master sensor data associated with the manipulation; and

wherein the manipulation instruction is based on the master sensor data.

Clause 92. The system of any clause herein, wherein the slave sensor data comprises slave force measurements;

wherein the master device comprises a master pressure system; and

wherein, using the slave force measurements, the master processing device is further configured to activate the master pressure system.

Clause 93. The system of any clause herein, further comprising:

a second master device comprising a second master pressure system; wherein the slave sensor data comprises slave force measurements; and

wherein, using the slave force measurements, the master processing device is further configured to activate the second master pressure system.

Clause 94. The system of any clause herein, wherein the master processing device is further configured to:

use the slave sensor data to transmit an augmented image to a master display.

Clause 95. The system of any clause herein, wherein the slave sensor data comprises slave force measurements;

wherein the augmented image comprises one or more pressure indicators; and

wherein the one or more pressure indicators are based on the slave force measurements.

Clause 96. The system of any clause herein, wherein the slave sensor data comprises slave temperature measurements;

wherein the augmented image comprises one or more temperature indicators; and

wherein the one or more temperature indicators are based on the slave temperature measurements.

Clause 97. The system of any clause herein, wherein the master device comprises a pressure gradient; and

wherein, using the pressure gradient, activating the slave pressure system comprises applying one or more measured levels of force to one or more sections of the treatment device.

Clause 98. The system of any clause herein, wherein the augmented image comprises a representation of at least one of the treatment device and a body part of the patient, and wherein the representation is in 2D or 3D.

Clause 99. The system of any clause herein, wherein the manipulation instruction comprises a measured level of force; and

wherein the measured level of force is based on a proximity of the master device to the representation.

Clause 100. The system of any clause herein, wherein the manipulation instruction is transmitted in real-time or near real-time; and

wherein the slave pressure system is activated in real-time or near real-time.

Clause 101. The system of any clause herein, wherein the master device comprises at least one of a glove device, a joystick, and a model of the treatment device.

Clause 102. The system of any clause herein, wherein the treatment device comprises at least one of a brace, a cap, a mat, and a wrap.

Clause 103. The system of any clause herein, further comprising:

a master memory device operatively coupled to the master processing device, wherein the master memory device stores master instructions, and wherein the master processing device is configured to execute the master instructions; and

a slave memory device operatively coupled to the slave processing device, wherein the slave memory device stores slave instructions, and wherein the slave processing device is configured to execute the slave instructions.

Clause 104. A method for operating a remote examination of a patient, comprising:

causing a master processing device to:

receive slave sensor data from the slave processing device;

use a manipulation of a master device to generate a manipulation instruction; and

transmit the manipulation instruction to the slave processing device; and

causing a slave processing device to:

receive the slave sensor data from the one or more slave sensors;

transmit the slave sensor data to the master processing device;

receive the manipulation instruction from the master processing device; and

use the manipulation instruction to activate the slave pressure system.

Clause 105. The method of any clause herein, wherein the master device comprises master sensors for detecting master sensor data associated with the manipulation; and

wherein the manipulation instruction is based on the master sensor data.

Clause 106. The method of any clause herein, wherein the slave sensor data comprises slave force measurements;

wherein the master device comprises a master pressure system; and

causing the master processing device, based on the slave force measurements, to activate the master pressure system.

Clause 107. The method of any clause herein, further comprising:

a second master device comprising a second master pressure system; wherein the slave sensor data comprises slave force measurements; and

wherein, using the slave force measurements, the master processing device is further configured to activate the second master pressure system.

Clause 108. The method of any clause herein, further causing the master processing device to:

use the slave sensor data to transmit an augmented image to a master display.

Clause 109. The method of any clause herein, wherein the slave sensor data comprises slave force measurements;

wherein the augmented image comprises one or more pressure indicators; and

wherein the one or more pressure indicators are based on the slave force measurements.

Clause 110. The method of any clause herein, wherein the slave sensor data comprises slave temperature measurements;

wherein the augmented image comprises one or more temperature indicators; and

wherein the one or more temperature indicators are based on the slave temperature measurements.

Clause 111. The method of any clause herein, wherein the master device comprises a pressure gradient; and

wherein, using the pressure gradient, activating the slave pressure system comprises applying one or more measured levels of force to one or more sections of the treatment device.

Clause 112. The method of any clause herein, wherein the augmented image comprises a representation of at least one of the treatment device and a body part of the patient, and wherein the representation is in 2D or 3D.

Clause 113. The method of any clause herein, wherein the manipulation instruction comprises a measured level of force; and

wherein the measured level of force is based on a proximity of the master device to the representation.

Clause 114. The method of any clause herein, wherein the manipulation instruction is transmitted in real-time or near real-time; and

wherein the slave pressure system is activated in real-time or near real-time.

Clause 115. The method of any clause herein, wherein the master device comprises at least one of a glove device, a joystick, and a model of the treatment device.

Clause 116. The method of any clause herein, wherein the treatment device comprises at least one of a brace, a cap, a mat, and a wrap.

Clause 117. A tangible, non-transitory computer-readable storage medium storing instructions that, when executed,

cause a master processing device to:

receive slave sensor data from the slave processing device;

use a manipulation of a master device to generate a manipulation instruction; and

transmit the manipulation instruction to the slave processing device; and

cause a slave processing device to:

receive the slave sensor data from the one or more slave sensors;

transmit the slave sensor data to the master processing device;

receive the manipulation instruction from the master processing device; and

use the manipulation instruction to activate the slave pressure system.

Clause 118. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the master device comprises master sensors for detecting master sensor data associated with the manipulation; and

wherein the manipulation instruction is based on the master sensor data.

Clause 119. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the slave sensor data comprises slave force measurements;

wherein the master device comprises a master pressure system; and

wherein, using the slave force measurements, the master processing device is further configured to activate the master pressure system.

Clause 120. The tangible, non-transitory computer-readable storage medium of any clause herein, further comprising:

a second master device comprising a second master pressure system; wherein the slave sensor data comprises slave force measurements; and

wherein, using the slave force measurements, the master processing device is further configured to activate the second master pressure system.

Clause 121. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein instructions further cause the master processing device to:

use the slave sensor data to transmit an augmented image to a master display.

Clause 122. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the slave sensor data comprises slave force measurements;

wherein the augmented image comprises one or more pressure indicators; and

wherein the one or more pressure indicators are based on the slave force measurements.

Clause 123. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the slave sensor data comprises slave temperature measurements;

wherein the augmented image comprises one or more temperature indicators; and

wherein the one or more temperature indicators are based on the slave temperature measurements.

Clause 124. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the master device comprises a pressure gradient; and

wherein, using the pressure gradient, activating the slave pressure system comprises applying one or more measured levels of force to one or more sections of the treatment device.

Clause 125. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the augmented image comprises a representation of at least one of the treatment device and a body part of the patient, and wherein the representation is in 2D or 3D.

Clause 126. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the manipulation instruction comprises a measured level of force; and

wherein the measured level of force is based on a proximity of the master device to the representation.

Clause 127. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the manipulation instruction is transmitted in real-time or near real-time; and

wherein the slave pressure system is activated in real-time or near real-time.

Clause 128. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the master device comprises at least one of a glove device, a joystick, and a model of the treatment device.

Clause 129. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the treatment device comprises at least one of a brace, a cap, a mat, and a wrap.

Clause 130. The tangible, non-transitory computer-readable storage medium of any clause herein, further comprising:

a master memory device operatively coupled to the master processing device, wherein the master memory device stores master instructions, and wherein the master processing device is configured to execute the master instructions; and

a slave memory device operatively coupled to the slave processing device, wherein the slave memory device stores slave instructions, and wherein the slave processing device is configured to execute the slave instructions.

Clause 131. A system for enabling a remote adjustment of a device, comprising:

a control system comprising one or more processing devices operatively coupled to the device, wherein the one or more processing devices are configured to:

receive a treatment plan for a patient;

use the treatment plan to generate at least one parameter; and

responsive to at least one trigger condition occurring, control at least one operation of the device.

Clause 132. The system of any clause herein, wherein the device comprises a sensor for detecting data associated with the at least one operation.

Clause 133. The system of any clause herein, wherein the one or more processing devices are configured to receive the data from the sensor in real-time or near real-time.

Clause 134. The system of any clause herein, wherein, to determine the at least one trigger condition, the one or more processing devices are configured to use at least one of the data, the at least one parameter, and a patient input.

Clause 135. The system of any clause herein, wherein the controlling of the at least one operation of the device comprises causing the device to modify at least one of a volume, a pressure, a resistance, an angle, a speed, an angular or rotational velocity, and a time period.

Clause 136. The system of any clause herein, wherein the at least one parameter is at least one of a force parameter, a resistance parameter, a range of motion parameter, a temperature parameter, a pain level parameter, an exercise session parameter, a vital sign parameter, and a time parameter.

Clause 137. The system of any clause herein, wherein the one or more processing devices are configured to receive the treatment plan from a clinical portal.

Clause 138. The system of any clause herein, wherein the one or more processing devices are further configured to:

transmit a notification to a clinical portal in real-time or near real-time; receive at least one adjusted parameter in real-time or near real-time; and

using the at least one adjusted parameter, control the at least one operation of the device in real-time or near real-time.

Clause 139. The system of any clause herein, wherein the one or more processing devices are further configured to:

transmit a notification to a clinical portal; receive at least one adjusted parameter; and

using the at least one adjusted parameter, control the at least one operation of the device at a time subsequent to receiving the at least one adjusted parameter.

Clause 140. The system of any clause herein, wherein the device comprises at least one of a physical therapy device, a brace, a cap, a mat, and a wrap.

Clause 141. A method for enabling a remote adjustment of a device, comprising:

receiving a treatment plan for a patient; using the treatment plan to generate at least one parameter; and

responsive to at least one trigger condition occurring, controlling at least one operation of the device.

Clause 142. The method of any clause herein, wherein the device comprises a sensor for detecting data associated with the at least one operation.

Clause 143. The method of any clause herein, wherein the data is received from the sensor in real-time or near real-time.

Clause 144. The method of any clause herein, further comprising:

to determine the at least one trigger condition, using at least one of the data, the at least one parameter, and a patient input.

Clause 145. The method of any clause herein, wherein the controlling of the at least one operation of the device comprises causing the device to modify at least one of a volume, a pressure, a resistance, an angle, a speed, an angular or rotational velocity, and a time period.

Clause 146. The method of any clause herein, wherein the at least one parameter is at least one of a force parameter, a resistance parameter, a range of motion parameter, a temperature parameter, a pain level parameter, an exercise session parameter, a vital sign parameter, and a time parameter.

Clause 147. The method of any clause herein, wherein the treatment plan is received from a clinical portal.

Clause 148. The method of any clause herein, further comprising:

transmitting a notification to a clinical portal in real-time or near real-time;

receiving at least one adjusted parameter in real-time or near real-time; and

using the at least one adjusted parameter to control the at least one operation of the device in real-time or near real-time.

Clause 149. The method of any clause herein, further comprising:

transmitting a notification to a clinical portal;

receiving at least one adjusted parameter; and

using the at least one adjusted parameter to control the at least one operation of the device at a time subsequent to receiving the at least one adjusted parameter.

Clause 150. The method of any clause herein, wherein the device comprises at least one of a physical therapy device, a brace, a cap, a mat, and a wrap.

Clause 151. A tangible, non-transitory computer-readable storage medium storing instructions that, when executed, cause a processor to:

receive a treatment plan for a patient; use the treatment plan to generate at least one parameter; and

responsive to at least one trigger condition occurring, control at least one operation of a device.

Clause 152. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the device comprises a sensor for detecting data associated with the at least one operation.

Clause 153. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the instructions further cause the processor to receive the data from the sensor in real-time or near real-time.

Clause 154. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein, to determine the at least one trigger condition, the instructions further cause the processor to use at least one of the data, the at least one parameter, and a patient input.

Clause 155. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the controlling of the at least one operation of the device comprises causing the device to modify at least one of a volume, a pressure, a resistance, an angle, a speed, an angular or rotational velocity, and a time period.

Clause 156. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the at least one parameter is at least one of a force parameter, a resistance parameter, a range of motion parameter, a temperature parameter, a pain level parameter, an exercise session parameter, a vital sign parameter, and a time parameter.

Clause 157. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the treatment plan is received from a clinical portal.

Clause 158. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the instructions further cause the processor to:

transmit a notification to a clinical portal in real-time or near real-time;

receive at least one adjusted parameter in real-time or near real-time; and

using the at least one adjusted parameter, control the at least one operation of the device in real-time or near real-time.

Clause 159. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the instructions further cause the processor to:

transmit a notification to a clinical portal; receive at least one adjusted parameter; and

using the at least one adjusted parameter, control the at least one operation of the device at a time subsequent to receiving the at least one adjusted parameter.

Clause 160. The tangible, non-transitory computer-readable storage medium of any clause herein, wherein the device comprises at least one of a physical therapy device, a brace, a cap, a mat, and a wrap.

Consistent with the above disclosure, the examples of assemblies enumerated in the following clauses are specifically contemplated and are intended as a non-limiting set of examples.

No part of the description in this application should be read as implying that any particular element, step, or function is an essential element that must be included in the claim scope. The scope of patented subject matter is defined only by the claims. Moreover, none of the claims is intended to invoke 25 U.S.C. § 104(f) unless the exact words “means for” are followed by a participle.

The foregoing description, for purposes of explanation, use specific nomenclature to provide a thorough understanding of the described embodiments. However, it should be apparent to one skilled in the art that the specific details are not required to practice the described embodiments. Thus, the foregoing descriptions of specific embodiments are presented for purposes of illustration and description. They are not intended to be exhaustive or to limit the described embodiments to the precise forms disclosed. It should be apparent to one of ordinary skill in the art that many modifications and variations are possible in view of the above teachings.

The above discussion is meant to be illustrative of the principles and various embodiments of the present invention. Once the above disclosure is fully appreciated, numerous variations and modifications will become apparent to those skilled in the art. It is intended that the following claims be interpreted to embrace all such variations and modifications. 

What is claimed is:
 1. A computer-implemented system, comprising: an electromechanical device configured to be manipulated by a user; an interface comprising an output device configured to present information; and a processing device configured to: receive a protocol for a user; during a session, use the protocol to generate at least one parameter; and responsive to at least one trigger condition occurring, control at least one operation of the electromechanical device, while the electromechanical device is operating, to facilitate user compliance with the protocol.
 2. The system of claim 1, wherein the electromechanical device comprises a sensor for detecting data associated with the at least one operation.
 3. The system of claim 2, wherein the processing device is configured to receive the data from the sensor in real-time or near real-time.
 4. The system of claim 3, wherein, to determine the at least one trigger condition, the one or more processing devices are configured to use at least one of the data, the at least one parameter, and a user input.
 5. The system of claim 1, wherein the controlling of the at least one operation of the electromechanical device comprises causing the electromechanical device to modify at least one of a volume, a pressure, a resistance, an angle, a speed, an angular or rotational velocity, and a time period.
 6. The system of claim 1, wherein the at least one parameter is at least one of a force parameter, a resistance parameter, a range of motion parameter, a temperature parameter, a pain level parameter, an exercise session parameter, a vital sign parameter, and a time parameter.
 7. A system for enabling a remote adjustment of a device, comprising: a control system comprising one or more processing devices operatively coupled to the device, wherein the one or more processing devices are configured to: receive a protocol for a user; use the protocol to generate at least one parameter; and responsive to at least one trigger condition occurring, control at least one operation of the device, while the device is operating, to facilitate user compliance with the protocol.
 8. The system of claim 7, wherein the device comprises a sensor for detecting data associated with the at least one operation.
 9. The system of claim 8, wherein the one or more processing devices are configured to receive the data from the sensor in real-time or near real-time.
 10. The system of claim 9, wherein, to determine the at least one trigger condition, the one or more processing devices are configured to use at least one of the data, the at least one parameter, and a user input.
 11. The system of claim 7, wherein the controlling of the at least one operation of the device comprises causing the device to modify at least one of a volume, a pressure, a resistance, an angle, a speed, an angular or rotational velocity, and a time period.
 12. The system of claim 7, wherein the at least one parameter is at least one of a force parameter, a resistance parameter, a range of motion parameter, a temperature parameter, a pain level parameter, an exercise session parameter, a vital sign parameter, and a time parameter.
 13. The system of claim 7, wherein the one or more processing devices are configured to receive the protocol from a clinical portal.
 14. The system of claim 7, wherein the one or more processing devices are further configured to: transmit a notification to a clinical portal in real-time or near real-time; receive at least one adjusted parameter in real-time or near real-time; and using the at least one adjusted parameter, control the at least one operation of the device in real-time or near real-time.
 15. The system of claim 7, wherein the one or more processing devices are further configured to: transmit a notification to a clinical portal; receive at least one adjusted parameter; and using the at least one adjusted parameter, control the at least one operation of the device at a time subsequent to receiving the at least one adjusted parameter.
 16. The system of claim 7, wherein the device comprises at least one of a physical therapy device, a brace, a cap, a mat, and a wrap.
 17. A method for enabling a remote adjustment of a device, comprising: receiving a protocol for a user; using the protocol to generate at least one parameter; and responsive to at least one trigger condition occurring, controlling at least one operation of the device, while the device is operating, to facilitate user compliance with the protocol.
 18. The method of claim 17, wherein the device comprises a sensor for detecting data associated with the at least one operation.
 19. The method of claim 18, wherein the data is received from the sensor in real-time or near real-time.
 20. The method of claim 19, further comprising: to determine the at least one trigger condition, using at least one of the data, the at least one parameter, and a user input. 